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Qalltg*  at  ^lryHtriana  mb  g»urtmmu 


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INTESTINAL    ILLS 


CHRONIC  CONSTIPATION  AND 
AUTO-INTOXICATION 

DUE   TO 

PROCTITIS  AND  COLITIS 


INTESTINAL 
ILLS 

CHRONIC  CONSTIPATION 

INDIGESTION 
AUTOGENETIC  POISONS 
DIARRHEA,  PILES,  ETC. 

ALSO 

AUTO-INFECTION,   AUTO-INTOXICA- 
TION,   ANEMIA,   EMACIATION,    ETC. 

DUE  TO 

PROCTITIS  AND  COLITIS 

PUBLISHED  BY  CHAS.  A.  TYRRELL,  M.D. 

Of 

134  West  65  th  Street,  New  York  City 
1913 


Copyright,  1901 

BV 

ALCINOUS  B.  JAMISON,  M.H. 

«»  weifr  «#?*  *Y?£f¥ 
wrw  vert*.  6'.  <?  A- 


?.  J.  Little  &  Ives  Co.,  New  York 


TO  ,  * 

THE  UNFORTUNATE  SUFFERER 

FROM  ILLS  DESCRIBED  IN  THIS  VOLUME 

AND  TO  THOSE  WHOM  I  HAVE  HAD 

THE  PLEASURE  OF  CURING 

THIS  BOOK 

IS  RESPECTFULLY 

DEDICATED 


Digitized  by  the  Internet  Archive 

in  2010  with  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/intestinalillsch1913jami 


BEAUTY'S  FALL. 

It  was  an  image  good  to  see, 
With  spirits  high  and  full  of  glee, 

And  robust  health  endowed  ; 
Its  face  was  loveliness  untold, 
Its  lines  were  cast  in  beauty's  mold  ; 

At  its  own  shrine  it  bowed. 

With  perfect  form  in  each  respect, 
It  proudly  stood  with  head  erect 

And  skin  surpassing  fair ; 
Surveyed  itself  from  foot  to  head, 
And  then  complacently  it  said  : 

"  Naught  can  with  me  compare." 

When  lo  the  face  began  to  pale, 
The  body  looked  too  thin  and  frail, 

The  cheek  had  lost  its  glow  ; 
The  tongue  a  tale  of  woe  did  tell, 
With  nerves  impaired  its  spirits  fell ; 

The  fire  of  life  burned  low. 

In  the  intestinal  canal 

Waste  matter  lay,  and  sad  to  tell, 

Was  left  from  day  to  day ; 
And  while  it  was  neglected  there 
It  undermined  that  structure  fair, 

And  caused  it  to  decay. 

The  doctor's  words  I  would  recall 
Who  said  :  "  Neglect  precedes  a  fall,' 

And  verily  't  is  true  ; 
For  ye  who  disregard  your  health, 
And  value  not  that  precious  wealth, 

Will  surely  live  to  rue. 


PREFACE. 

THE  following  chapters  were  contribu- 
tions to  Health  —  a  monthly  maga- 
zine published  in  New  York  City.  Certain 
peculiarities  of  form  and  considerable 
repetition  of  statement  — ■  both  of  which 
the  reader  cannot  fail  to  notice  —  are  ow- 
ing to  the  fact  that  about  two-thirds  of 
the  chapters  were  written  under  the  cap- 
tion "  Auto-genetic  Poisons  in  the  Intes- 
tinal Canal  and  their  Auto-infection." 
In  revising-  these  contributions  for  book 
form  I  have  given  to  each  chapter  a  cap- 
tion of  its  leading  thought ;  but  I  am 
convinced  that  repetition  of  some  of  the 
matters  treated,  especially  if  the  repeti- 
tion be  in  a  somewhat  different  connec- 
tion, is  not  such  a  very  bad  thing.  I 
have  used  my  blue  pencil  sparingly,  and 
as  a  consequence  the  consecutive  reader 
will  find  that  constipation,  diarrhea,  bil- 
iousness,   indigestion,   auto-infection   and 


Preface 

proctitis  are  treated  in  nearly  all  the 
chapters  —  but  with  varying  applications. 
Therefore  anyone  suffering  from  one  of 
these  complaints  would  better  read  the 
whole  book  instead  of  only  the  chapter 
with  the  corresponding  title. 

These  pages  were  written  for  intelli- 
gent laymen  by  a  specialist,  during  a  busy, 
assiduous  practice.  I  take  such  radical 
ground,  however,  going  to  the  very  root 
of  the  matter,  that  the  general  practi- 
tioner will  do  well  to  give  my  thesis  his 
careful  consideration  ;  he  should  at  least 
glance  at  the  following  Introduction  for 
the  gist  of  my  claim. 


CONTENTS. 

CHAPTER  I. 

Man,  Composed  almost  wholly  of  Water, 
is  Constipated.     Why  ?   .         .        .         .       i 

CHAPTER  II. 

The  Physics  of  Digestion  and  Egestion    .     12 

CHAPTER  III. 

The  Interdependence  of  Anus,   Rectum, 
Sigmoid  Flexure  and  Colon  .         .        .24 

CHAPTER  IV. 
Indigestion,  Intestinal   Gas  and   Other 
Matters 29 

CHAPTER  V. 

Key  to  Auto-Infection        .        .        .        .36 

CHAPTER  VI. 

How  Auto-Infection  Affects  the  Gastric 
Digestion,  and  Vice  Versa     .        .        .46 

CHAPTER  VII. 

How  Auto-Infection  Affects  Intestinal 
Digestion,  and  Vice  Versa     .         ,        .     56 


Contents 

CHAPTER  VIII.  PAGK 

The  Cause  of  Constipation  and  how  we 
ignorantly  treat  it  .        .         .64 

CHAPTER  IX. 
Cures  for  Constipation:  "Fearfully  and 
Wonderfully  Made"       .        .        .        .71 

CHAPTER  X. 

Biliousness  and  Bilious  Attacks         .        .     78 

CHAPTER  XI. 
King  Liver  and  Bile-Bouncers    .        .        .83 

CHAPTER  XII. 

Semi-Constipation  and  its  Dangers    .        .     89 

CHAPTER  XIII. 
The  Etiology  of  the  most  Common  Form 
of  Diarrhea,  i.e.,  Excessive  Intestinal 
Peristalsis 98 

CHAPTER  XIV. 
Ballooning  of  the  Rectum  ....  107 

CHAPTER  XV. 

Ballooning  of  the  Rectum — continued        .  117 

CHAPTER  XVI. 
The  Usual  Diagnosis  and  Treatment  of 
Bowel  Troubles  Wrong  .         .        .        .126 


Contents 

CHAPTER  XVII.  PAGE 

COSTIVENESS 132 

CHAPTER  XVIII. 
Inflammation 137 

CHAPTER  XIX. 
Proctitis  and  Piles 148 

CHAPTER  XX. 

Pruritus  or  Itching  of  the  Anus       .        .  156 

CHAPTER  XXI. 
Abscess  and  Fistula 164 

CHAPTER  XXII. 
The  Origin  and  Use  of  the  Enema     .        .  173 

CHAPTER  XXIII. 

How  often  should  an  Enema  be  Taken  ?  .  180 

CHAPTER  XXIV. 
Man's  Best  Friend 190 

CHAPTER   XXV. 
Physiological  Irrigation     ....  191 

CHAPTER  XXVI. 
Proper  Treatment  for  Diseases  of  Anus 
and  Rectum  Essential  ....  202 
xiii 


Contents 

CHAPTER  XXVII. 
The  Body's  Book-keeping     ....  215 

CHAPTER  XXVIII. 

Selection  and  Preparation  of  Food  .        .  220 

CHAPTER  XXIX. 
Diet  for  Indigestion 227 

CHAPTER  XXX. 

Diet  for  Constipation  and  Obstipation    .  231 

CHAPTER  XXXI. 
Costiveness,  Diet,  etc.  ....  235 

CHAPTER  XXXII. 
Diet  for  Diarrhea 237 

A  Final  Word 240 

NO.  1. 
Chronic   Constipation   and   the  Use  of 

the  Enema 245 

NO.  2. 
Objections     to     the     Use     of     Enema 

Answered 257 


INTRODUCTION. 

THE  keynote  of  this  book  is  Proctitis, 
inflammation  of  the  anal  and  rectal 
canals.  Hardly  a  civilized  man  escapes 
proctitis  from  the  day  of  the  diaper 
to  that  of  death.  The  diaper  is  in 
truth  chiefly  responsible  for  proctitis, 
and  proctitis  is  in  turn  chiefly  respon- 
sible for  chronic  constipation,  chronic 
diarrhea,  auto-infection  ;  and  hence  for 
mal- assimilation,  mal  -  nutrition,  anemia; 
and  for  a  thousand  and  one  reflex  func- 
tional derangements  of  the  system  as 
well.  The  inflamed  surface  of  the  intes- 
tinal canal  (proctitis)  inhibits  the  passage 
of  feces.  Absorbent  glands  begin  to  act 
on  the  retained  sewage,  and  the  whole 
system  becomes  more  or  less  infected 
with  poisonous  bacteria.  Various  organs 
(especially  the  feeblest)  endeavor  to  per- 
form vicarious  defecation,  and  the  patient, 
the   friends,  and  even  the  physician   are 


Introduction 

deceived  by  such  vicarious  performance 
into  thinking1  and  treating  it  as  a  local  ail- 
ment.  I  cannot,  accordingly,  insist  too 
emphatically  that  proctitis,  the  exciting 
cause,  must  be  treated  primarily  if  we 
would  cure  chronic  constipation.  Millions 
of  human  beings  are  sent  to  untimely 
graves  by  these  ailments.  Indeed,  the 
body  of  nearly  every  human  being  is  a 
pest-house  of  absorbed  poison  instead  of 
being  the  worthy  temple  of  a  wondrous 
soul.     All  due  to  Proctitis  ! 


XVI 


INTESTINAL  ILLS 


CHAPTER  I. 

MAN,  COMPOSED  ALMOST  WHOLLY  OF  WATER, 
IS   CONSTIPATED.      WHY? 

NATURALLY  the  mind  of  man  was 
first  educated  to  observe  external 
objects  and  forces  in  their  effects  upon 
himself,  and  the  external  still  continues  to 
engross  his  attention  as  if  he  were  a  child 
in  a  kindergarten.  Fascinated  by  the 
Without,  he  ignores  the  Within.  But, 
marvel  of  marvels,  Disease  (which  when 
looked  at  with  discerning  eyes  is  seen  to 
be  an  angel  in  disguise)  comes  to  enlighten 
him  concerning  the  world  within.  Dis- 
ease gradually  acquaints  him  with  the  fact 
that  there  are  within  him  organs  and 
functions    corresponding   to    the    objects 


Intestinal  Ills 

and  forces  in  the  world  without, — servitors 
in  fact  which  must  not  be  ignored  under 
penalty  of  transforming  them  into  foes  to 
his  well-being.  Disease  makes  him  aware 
that  by  ignoring  the  claims  of  his  inner 
relations  he  has  been  converting  his  very 
food,  juices  and  gases  into  insidious  and 
formidable  poisons,  which  perforce  he  ab- 
sorbs into  his  blood  and  tissues  and  circu- 
lates throughout  his  entire  system.  Thus 
does  the  disguised  anorel  admonish  the  iq-. 
norant  that  the  rights  of  the  inner  world 
must  not  be  ignored — that  one's  duties 
thereto  cannot  be  neglected  without  dis- 
astrous consequences. 

Thus  does  Pathology,  which  is  really 
Physiology  reversed,  become  the  self-re- 
vealer  par  excellence.  Through  digestion 
and  assimilation  the  physiological  process 
takes  up  the  food,  juices  and  gases,  to 
support  and  augment  the  life  of  man. 
The  pathological  process,  on  the  contrary, 
because  the  conditions  for  nutrition  are 
ignored,  reverses  the  upbuilding  pro- 
cesses ;    and   the    organs    of   life    wither, 

2 


Intestinal  Hygiene 

waste  and  weaken,  until  life  goes  out  like 
fire  unfed. 

Man  has  been  slowly  learning  to  take 
sanitary  measures  in  reference  to  every- 
thing that  contributes  to  comfort  in  his 
surroundings,  and  hygienic  measures  in 
reference  to  everything  conducive  to  sta- 
bility in  his  health. 

Through  ages  he  has  learned,  by  ex- 
perience and  experiment,  of  the  changes 
that  inevitably  occur  in  such  perishable 
nutritive  substances  as  water,  milk,  meats, 
vegetables,  fruits,  etc.,  if  they  be  left  un- 
cared  for  ;  and  he  has  been  led  thus  to 
the  inference  of  the  law  of  decomposi- 
tion—  or  putrefactive  and  fermentative 
changes.  Idle  substances,  like  idle  minds, 
have  decomposition  and  the  devil  for 
companions.  Substances  confined  in  con- 
tainers open  to  the  air — ponds,  cesspools, 
etc. — are  every-day  object  lessons  to  man 
of  the  fact  that  the  chemical  changes  they 
undergo  furnish  the  conditions  for  breed- 
ing bacterial  poisons,  and  that  these  poi- 
sons are  a  dread  menace  to  animal  life. 
3 


Intestinal  Ills 

If  the  reader  will  observe  the  analogy 
between  the  decomposition  of  substances 
in  vessels  or  pools,  and  the  decomposition 
of  food  in  the  reservoir  called  the  stom- 
ach ;  and  its  further  decomposition  in  a 
long  canal  (the  small  intestine),  connect- 
ing the  stomach  with  other  receptacles 
called  the  colon  and  sigmoid  flexure  ;  and 
then  the  decomposition  of  their  contents ; 
he  will  readily  comprehend  the  chemical 
putrefactive  or  fermentative  changes  or 
bacterial  action  that  take  place  in  the 
organism,  if  for  any  reason  the  contents 
be  confined. 

Of  the  four  chief  elements  that  enter 
into  the  composition  of  living  bodies 
three  are  gaseous,  or  convertible  into 
gas.  In  the  physical  man  water  con- 
stitutes three-fourths  of  the  weight  of  the 
body.  This  being  so  we  realize  why, 
notwithstanding  our  sense  of  solidity  and 
weight,  chemical  changes  occur  quite  as 
readily  in  our  organism  as  in  the  sub- 
stances we  see  about  us.  There  are  no 
waterproof  walls  in  the  body  of  man  to 


Intestinal  Hygiene 

impede  the  percolation  of  liquids  freighted 
with  promiscuous  Passengers  from  the 
alimentary  canal ;  Passengers  designed  to 
nourish  the  organs  for  which  they  have 
an  affinity.  But  there  are  those  that  have 
no  organic  affinity,  and  these  are  tramps, 
vagabonds,  and  even  murderers,  disturb- 
ing and  destroying  the  normal  functions 
of  the  system.  Through  extravasation, 
that  is,  through  fluid  infiltration  of  tissues, 
these  Passengers  come  to  be  one  with 
us,  and  we  make  them  part  of  our  tissue ; 
but  some  of  the  Passengers  are  the  de- 
molishers  of  the  living  temple. 

Water  is  universally  present  in  all  the 
tissues  of  the  body,  and  it  is  indispensable 
for  introducing  new  substances  into  the 
system  and  for  eliminating  the  worn-out 
tissues  and  foreign  substances.  It  is  in- 
deed important  to  emphasize  the  fact  that 
properly  to  eliminate  the  foreign  and 
waste  products  from  the  system  requires, 
in  a  healthy  person,  at  least  five  pints  of 
water  during  twenty-four  hours. 

The  amount  of  gastric  juice  secreted  in 
5 


Intestinal  Ills 

twenty-four  hours  is  from  six  to  fourteen 
pints  ;  of  pancreatic  juice,  one  pint ;  of 
bile  there  are  two  to  three  pints,  and  of 
saliva  one  to  three  pints.  It  is  estimated 
that  the  juices  secreted  during  digestion 
in  a  man  weighing  140  pounds  amount  to 
twenty-three  pounds  in  twenty-four  hours. 
These  fluids  are  poured  back  and  forth 
in  the  process  of  transforming  food  into 
flesh  and  eliminating  waste  material. 

In  the  alimentary  canal  there  are  ves- 
sels for  holding  fluid,  semi-fluid  and  moist 
masses  of  substance,  in  all  of  which  de- 
composition occurs  if  the  substances  be 
retained  beyond  the  normal  length  of 
time.  These  vessels  or  reservoirs  are  the 
stomach,  duodenum,  small  intestines,  co- 
lon, sigmoid  flexure,  and  too  often  the 
rectum.  Through  the  harmonious  action 
of  this  intestinal  retinue  of  servitors  man 
is  well  equipped  and  qualified  for  health, 
and  he  in  whom  this  harmonious  subser- 
vience prevails  is  among  the  blessed  and 
elect  of  mankind.  But  alas !  the  great 
majority  of  human   beings  are  sufferers 

6 


Intestinal  Hygiene 

from  the  inharmonious  and  insubordi- 
nate action  of  these  servitors.  How 
many  a  human  being  suffers  from  chronic 
constipation  and  indigestion,  the  exciting 
causes  of  which  are  insidious,  and  the 
consequences  a  protean  enemy  to  his 
happiness !  Medical  writers  on  the  sub- 
ject of  chronic  constipation  have  assigned 
numerous  causes,  and  likewise  prescribed 
multitudinous  remedies  to  the  patient ; 
but  as  a  general  rule  this  patient,  after 
suffering  various  woes,  if  still  surviving 
the  many  years  of  medication,  rebels 
against  taking  further  remedies  and  re- 
signs himself  to  the  chronic  enemy  on  the 
best  terms  he  can  make  with  diet. 

For  this  large  class  of  chronic  sufferers 
we  have  good  news ;  and  for  the  class 
that  have  suffered  five  or  ten  years  we 
have  better  news  ;  and  for  the  class  of 
infants  and  children  that  have  started  on 
the  road  of  ill-health  we  have  real  glad 
tidings.  To  know  that  there  is  only  one 
chief  cause  for  chronic  constipation  and 
its  train  of  disorders,  and  that  that  cause 

7 


Intestinal  Ills 

overshadows  all  other  causes  combined, 
and  is  easily  diagnosed  and  treated,  is 
news  long  hoped  and  prayed  for  by  a 
multitude  of  sufferers  the  world  over. 

Twenty  years  as  a  specialist  in  diseases 
of  the  lower  bowels  have  demonstrated 
to  the  writer  that  chronic  inflammation, 
and  often  ulceration,  of  the  rectum  and 
sigmoid  flexure,  in  ninety-nine  cases  out 
of  a  hundred,  is  the  cause  of  chronic  con- 
stipation and  the  long  army  of  ills  result- 
ing from  it.  And  yet,  as  the  reader  is 
well  aware,  constipation  has  had  many 
"  causes,"  since  the  days  of  Hippocrates, 
especially  the  abnormal  condition  of  the 
liver. 

The  etiology,  that  is,  the  exciting  cause, 
of  the  inflammation  of  the  anus,  rectum, 
colon,  etc.,  may  date  from  the  time  a 
diaper  was  placed  on  the  new-born  infant. 
Excoriations  of  the  integument  about  the 
anus  by  the  excretions  of  bowels  and 
bladder  indicate  that  the  mucous  mem- 
brane of  anus  and  rectum  demands  lo- 
cal remedies,  as  well  as  the  integument 


Intestinal  Hygiene 

of  the  buttocks,  and  that  it  is  not  the 
liver  which  is  at  fault.  The  many  appli- 
cations of  the  diaper  during  the  period 
of  its  use,  and  the  frequently  delayed 
removal  at  night  or  during  long  rides 
in  baby  wagons,  railway  trains  or  car- 
riages, and  during  long  social  visits  of  the 
nurse ;  constipating  foods,  lack  of  drink- 
ing water,  constipating  medicines,  followed 
by  all  sorts  of  purgatives,  etc.,  are  among 
a  few  of  the  direct  causes  of  diseases  of 
the  rectum.  A  child  at  the  age  of  eigh- 
teen months  with  a  healthy  rectum  is  most 
rare. 

The  ten  thousand  and  one  chances  for 
contracting  disease  of  the  anus  and  rectum 
do  not  cease  with  the  period  of  infancy. 
The  child  is  left  pretty  much  to  shift  for 
itself  as  to  regularity  of  eating  and  the 
evacuation  of  the  contents  of  its  bowels, 
wherein  disease  has  already  obtained  a 
foothold.  All  kinds  of  foodstuffs,  at  all 
hours,  with  seeds,  stones,  etc.,  are  poked 
into  its  stomach,  followed  by  constipating 
remedies  to  quiet  inevitable  troubles,  or 

9 


Intestinal  Ills 

brisk  purgatives  given  with  the  hope  of 
expelling  the  arrested  contents  of  the 
bowels.  Is  it  any  wonder  that  ninety- 
eight  persons  of  adult  age  out  of  every 
hundred  suffer  more  or  less  from  chronic 
inflammation  and  ulceration  of  anus,  rec- 
tum, sigmoid  flexure,  colon,  or  appendix  ? 
Traumatic  (externally  produced)  inju- 
ries to  the  mucous  membrane  of  the 
rectum  frequently  cause  inflammation, 
and  hard  pieces  of  bone,  wood,  seeds, 
imbedded  in  the  feces,  scratch,  cut  and 
bruise  the  tissues  before  and  during  the 
act  of  defecation.  Cold  boards,  stones, 
earth  and  other  substances  used  as  seats 
may  produce  inflammation  of  the  rectum. 
There  are  many  and  various  causes  which 
may  be  the  means  of  exciting  inflamma- 
tion of  the  anus  and  rectum  later  in  life ; 
but  it  is  the  writer's  opinion  that  the 
cause  can  be  traced  back  to  infancy  or 
early  childhood,  and  that  accidents  or 
imprudence  in  after  years  merely  excite 
an  already- existing  chronic  inflamma- 
tion.    Piles,  fissure,  itching  pockets,  tabs, 

to 


Intestinal  Hygiene 

prolapse,  abscesses,  fistulae,  etc.,  are  only 
the  outcome  and  symptoms  of  a  chronic 
disease  which  has  incubated  for  fifteen, 
twenty  or  more  years.  None  of  this  list 
of  troubles  produces  constipation.  It  is 
the  inflammation  located  at  the  middle 
portion  of  the  rectum  and  extending  into 
the  sigmoid  flexure  that  causes  constipa- 
tion ;  that  protean  monster  which  de- 
ranees  more  lives  with  nervousness  than 
any  other  pathological  condition  to  which 
the  flesh  of  man  is  heir  ! 


IX 


CHAPTER   II. 

THE  PHYSICS  OF  DIGESTION  AND  EGESTION. 

A  TREE  is  simply  an  extension  from 
its  roots  ;  and,  in  an  analogous  man- 
ner, man's  body  may  be  said  to  be  an 
extension  from  the  alimentary  canal. 
Does  it  not  follow,  consequently,  that 
the  digestive  apparatus,  from  a  physio- 
logical point  of  view,  is  the  most  import- 
ant organ  of  the  human  body  ?  It  must 
be  prime  and  paramount  because  all 
other  organs  depend  upon  it  :  it  provides 
them  with  nourishment  for  preservation 
and  improvement,  and  it  punishes  them  — 
if  they  do  not  mind  the  laws  of  normal- 
ity—  by  withholding  its  gifts,  or  by- 
presenting  these  gifts  in  the  form  of 
poisons  that  impoverish,  hinder  and  de- 
generate the  system  of  organs.  Unclean- 
liness  is  surely  one  of  the  chief  ways  in 
which     physiological     thoughtlessness    is 

12 


Digestion  and  Egestion 

exhibited,  and  due  punishment  will  in- 
evitably follow  disobedience. 

Foodstuffs  are  prepared  for  assimila- 
tion in  the  alimentary  laboratory  through 
the  process  of  normal  fermentation.  Is 
it  not  essential,  therefore,  that  the  con- 
necting canals  and  receptacles  be  cleansed 
of  the  fermented  debris  that  may  remain 
unused  and  unexpelled,  before  more  food 
be  taken  by  the  digestive  apparatus  ? 
The  all -important  question  is:  —  How 
soon  and  how  well  have  the  residuary 
part  of  the  food  (for  some  part  will  always 
be  undigested  or  unassimilated),  and  the 
waste  resulting  from  worn-out  tissues  of 
the  various  organs,  been  eliminated  from 
the  system  ?  Wisdom  declares  that  it 
is  not  so  much  what  we  eat,  but  what 
and  how  well  we  eliminate,  that  decides 
the  issues  of  health  and  disease.  Do  the 
egesta  pass  out  in  the  form  of  normal 
feces  ?  Three  times  in  twenty-four  hours 
foodstuffs  are  taken,  and  as  many  times 
the  bowels  should  be  freed  of  accumulated 
excrement  and  gases.     Does  Nature  have 

13 


Intestinal  Ills 

her  way,  or  do  neglect  and  bad  habits  rule 
the  assimilative  and  eliminative  functions 
of  the  bowels  ? 

The  habit  of  storing  feces  for  twenty- 
four  hours  ought  to  concur  and  keep  pace 
with  a  habit  of  eating  one  meal  in  the 
same  period.  Household  and  laboratory 
receptacles  in  which  fermentation  has  oc- 
curred are  emptied  and  cleaned  before 
fresh  material  is  put  into  them.  Is  not 
the  same  precaution  more  essential  with 
the  receptacles  for  digestion  and  egestion  ? 
They  constitute  our  chief  physiological 
economy  ;  they  are  precious  household  and 
laboratory  utensils  ;  exceedingly  precious, 
as  we  can  purchase  no  other  set  when 
these  are  worn  and  wasted  beyond  repair. 
What  marvelous  possessions,  and  how 
reckless  most  of  us  are  with  them ! 
Neither  love  nor  money  will  bring  an- 
other "body  "-house  to  us  when  this  de- 
cays ;  when  poisons  or  parasites  infest  it 
as  the  result  of  a  pernicious  diathesis,  of 
debasing,  destructive  tendencies  ;  in  short, 
of  unmindfulness  ! 

14 


Digestion  and  Egestion 

Too  often  criminal  negligence  or  the 
lack  of  proper  convenience  has  brought 
on  the  habit  of  using  the  intestinal  canal 
as  a  storehouse  for  dried  feces,  and  the 
glands  and  blood-vessels  as  reservoirs  for 
the  absorbed  fluid  poisons  from  the  feces 
that  have  been  stored  and  thus  dried.  This 
baneful  habit  is  general  throughout  civil- 
ized communities.  It  is  this  habit  that 
has  made  the  words  "constipation,"  "in- 
digestion," "  diarrhea,"  etc.,  familiar  and 
household  subjects  of  complaint.  Medical 
writers  agree  that  "  constipation  "  is  the 
most  common  malady  that  afflicts  man- 
kind ;  but  they  are  also  unanimous  in  pre- 
posterously attributing  the  cause  to  the 
abnormal  action  of  the  liver  and  the  sec- 
ondary symptoms  of  constipation. 

Chronic  constipation  is  the  result  of 
proctitis  and  colitis.  Proctitis,  the  inflam- 
mation of  the  rectal  and  anal  canals,  is 
the  most  common  disease  that  afflicts  the 
human  creature  from  infancy  to  old  age  ; 
and  colitis,  is  only  the  extension  of  proc- 
titis to  the  colon. 
15 


Intestinal  Ills 

The  scientific  diagnosis  of  constipation 
predicates  proctitis  and  sometimes  colitis. 
It  is  declared  that  constipation  is  its  pri- 
mary symptom  ;  and  that  diarrhea  is  one 
of  its  secondary  symptoms,  resulting  from 
constipation.  There  is  a  legion  of  second- 
ary symptoms  of  proctitis,  all  of  which 
medical  empiricism  considers  and  denom- 
inates causes.  As  constipation  is  such 
an  every-day  complaint  of  almost  every- 
body one  meets,  it  will  not  tax  our  im- 
agination unduly  to  conceive  how  it  may 
be  a  frequent  cause  of  diarrhea,  which  is 
only  Nature's  effort  to  get  rid  of  its  useless 
and  excessive  burden  of  retained  feces  and 
gases.  Constipation,  semi-constipation, 
and  irregular  action  of  the  bowels,  exces- 
sive fermentation,  putrefaction,  self-gen- 
erated or  auto-infection,  are  the  factors 
to  be  considered.  It  is  to  be  noted  that 
in  many  cases  diarrhea  is  simply  an  in- 
creased peristalsis  of  the  bowels,  often 
due  to  local  and  diffused  irritation  and 
often  to  inflammation  of  the  mucous  mem- 
brane (not  infrequently  with  ulceration)  ; 

16 


Digestion  and  Egestion 

all  of  these  may  be  the  outcome  of  fecal 
impaction. 

To  make  intelligible  the  physics  of  the 
digestive  and  egestive  processes,  we  must 
understand  the  apparatus.  One  would 
naturally  think  that  were  the  bends  or 
curves  of  the  large  intestine  undone,  it 
would  be  found  to  be  a  long,  straight, 
smooth  canal  or  bore  like  a  rubber  tube. 
But  such  is  not  the  case.  The  outer 
muscular  longitudinal  bands  are  much 
shorter  than  the  musculo-areolo-mucous 
tube,  an  arrangement  which  brings  about 
a  transverse  puckering  of  the  gut  and 
mucous  membrane,  thus  forming  valves, 
folds,  sacs  or  pouches  at  short  intervals 
along  the  canal.  These  transverse  folds 
or  valves  inhibit  the  too  hasty  passage 
of  the  feces  along  the  bowels  by  check- 
ing and  retaining  the  egested  product 
in  the  large  recesses  or  pools  between  the 
folds ;  they  thus  serve  as  so  many  dams 
in  the  passage  of  feces  toward  elimi- 
nation. This  wise  provision  of  Nature 
to    moderate   the   steady  motion   of   the 

17— « 


Intestinal  Ills 

feces  as  they  proceed  toward  the  sigmoid 
flexure  or  receptacle,  to  wait  there  till 
there  is  a  proper  stimulus  for  expulsion, 
is  wofully  abused  by  man.  He  is  quite 
willing  to  take  foodstuffs  three  or  four 
times  a  day,  to  fill  the  long  row  of  intes- 
tinal pools  between  the  dams  with  feces 
and  gases  in  all  stages  of  decomposition, 
not  dreaming  of  the  danger  from  develop- 
ing bacteria  and  their  absorption  into  the 
system. 

Really  he  is  inclined  to  eat  at  all  times, 
yet  begrudges  a  few  minutes  spent  in  a 
hurried  effort  to  perform  the  act  of  defe- 
cation once  in  twenty-four  hours.  Some 
of  us  even  have  our  minds  absorbed  in 
reading  while  awaiting  an  "  automatic 
action  "  of  the  bowels.  What  a  contrast 
between  the  gusto  and  time  spent  in  tak- 
ing foodstuffs  and  the  indifference  and 
indolence  reofardino-  the  action  of  the  bow- 
els,  unless  indeed  severe  biliousness  or 
diarrhea  reminds  us  strongly  of  our  sewer 
of  waste  products. 

An  attack  of  acute  or  chronic  diarrhea 

iS 


Digestion  and  Egestion 

is  the  penalty  some  pay  for  long  inatten- 
tion to  the  demands  nature  makes  for 
intestinal  cleanliness  three  times  in  twen- 
ty-four hours.  Constipated  people,  semi- 
constipated  people,  irregular  people  and 
twenty-four-hour  people,  are  not  healthy. 
They  are  constantly  being  poisoned  by 
the  abnormal  products  of  indigestion  and 
putrefaction  resulting  from  fecal  stagna- 
tion, which  products  enter  the  blood  and 
circulate  through  every  tissue  of  the 
body. 

All  cases  of  proctitis  are  more  or  less 
accompanied  by  constipation  and  diar- 
rhea. In  all  cases  of  chronic  constipa- 
tion I  have  found  proctitis,  and  often 
colitis,  and  am  forced  to  believe  it  is  the 
most  common  and  proximate  cause  of 
chronic  constipation  of  the  bowels.  Con- 
stipation being  a  primary  symptom,  there 
must  of  necessity  follow  numerous  sec- 
ondary symptoms,  of  which  diarrhea 
well  marks  the  progress  of  septic  in- 
fection. Some  of  the  symptoms  of  in- 
fection are  headache,  megrim,  vertigo, 
19 


Intestinal  Ills 

dyspepsia,  foul  tongue  and  mouth,  back- 
aches, stiff  neck,  gnawing  pain  or  numb 
feeling  at  the  lower  end  of  the  spine, 
biliousness,  bad  odor  from  breath  and 
skin,  muddy  complexion,  cold  hands  and 
feet,  jaundice,  neurasthenia,  loss  of  mem- 
ory, drowsy  feeling,  pernicious  anemia, 
emaciation,  flabby  obesity  with  pallor, 
capricious  appetite,  fits  of  great  mental 
depression,  palpitation  of  the  heart,  bloat- 
ing of  the  stomach  and  bowels,  disturbance 
of  the  kidneys,  liver,  lungs  and  mucous 
membrane  in  general,  and  especially 
chronic  rhinitis  and  pharyngitis,  which 
latter  are  among  the  first  symptoms  of 
imperfect  alimentary  excretion. 

As  auto-intoxication  (that  condition  of 
the  system  when  it  is  continually  poisoned, 
usually  by  one's  own  excretions)  gains  the 
mastery  of  the  vital  forces  at  any  period  of 
life,  the  mucous  membranes  are  likely  to 
be  first  affected  by  inflammation  of  ca- 
tarrhal character ;  then  the  serous  mem- 
branes   of    the    body.      Mal-assimilation, 

mal-nutrition,  cell-atrophy,  are  symptoms 

20 


Digestion  and  Egestion 

of  the  giving  way  of  the  vital  energies  to 
the  invasion  of  the  filth  and  bacterial  poi- 
sons absorbed  from  the  intestinal  canal. 

On  the  inner  surface  of  the  alimentary 
canal,  from  the  stomach  to  the  colon, 
there  are,  it  is  estimated,  over  20,000,000 
rootlets  (called  glands,  lacteals,  follicles, 
villi),  which  take  up  intestinal  juices  as 
roots  of  a  plant  take  sap  from  the  soil. 
These  millions  of  rootlets  give  a  velvety 
appearance  to  the  alimentary  canal,  like  a 
nap  or  downy  surface.  Intestinal  root- 
lets of  the  small  intestines,  like  vegetal 
rootlets,  demand  a  certain  amount  of  nor- 
mal fluid  and  solid  substance,  free  from 
noxious  gas.  It  is  the  down  or  nap  of 
fabrics,  and  not  their  body,  that  shows 
damage  first.  So  it  is  with  the  frail 
structure  of  vegetal  and  animal  life  if  not 
properly  supplied  with  nourishment  from 
day  to  day.  There  is  probably  in  the  veg- 
etal bodies  a  continuous  circulation  of  sap 
corresponding  to  the  digestive  circulating 
fluids  of  the  alimentary  canal.  This  cir- 
culation from  the  alimentary  canal  to  the 

21 


Intestinal  Ills 

blood-vessels,  and  from  the  blood-vessels 
to  the  alimentary  canal,  involves  a  won- 
derful mechanism,  facilitating"  the  flow  of 
several  gallons  daily  from  each  to  the 
other  during  the  process  of  metamor- 
phosis of  food  into  flesh.  You  can  thus 
see  how  inevitable  it  is  that  the  functions 
of  these  millions  of  secreting  and  excret- 
ing rootlets  will  be  disturbed  by  the 
clogging  of  the  system  with  filth  and 
bacterial  poisons  as  a  consequence  of 
chronic  constipation,  biliousness  and  gen- 
eral foulness  of  the  alimentary  canal. 
Through  such  disturbance  nutrition  is 
diminished,  cell-atrophy  progresses,  and 
emaciation  becomes  more  marked.  The 
progressive  destruction  of  these  rootlets, 
involving  the  pathological  change  indi- 
cated, will  be  manifest  in  one  of  its  results, 
either  costiveness  or  diarrhea. 

Often  the  power  of  properly  digesting 
and  absorbing  the  foodstuffs  is  so  greatly 
diminished  that  the  alimentary  canal  is 
about  as  useless  as  a  soft  rubber  tube. 
Millions  on  millions  of  these  glands,  lac- 


Digestion  and  Egestion 

teals  and  follicles  in  the  stomach  and 
small  intestines,  are  destroyed  like  the 
rootlets  of  a  plant  or  tree  in  unwholesome 
soil.  The  active  circulation  of  the  dicrest- 
ive  fluids  ceases,  and  the  sufferer  is  said 
to  be  costive  or  to  have  chronic  diarrhea. 
Both  symptoms  are  the  outgrowth  of 
many  years  of  intestinal  foulness,  and  in- 
dicate the  degree  and  character  of  intes- 
tinal irritability  and  semi-starvation  of  the 
body,  as  a  consequence  of  either  the  ab- 
sorption of  poisons  or  the  excessive  elim- 
ination of  the  vital  substance  of  the  body 
through  diarrhea. 


S3 


CHAPTER  III. 

THE    INTER-DEPENDENCE    OF    ANUS,   RECTUM, 
SIGMOID    FLEXURE,   AND   COLON. 

PHYSIOLOGICALLY,  or  in  a  nor- 
mal state,  the  rectum  is  not  a  recep- 
tacle for  liquids  and  feces  but  a  conduit 
during"  the  act  of  defecation.  Should, 
therefore,  the  feces  have  passed  into  the 
rectum  and  the  desire  to  stool  be  not  re- 
sponded to — though  the  desire  continue 
urgent — the  feces  will  be  returned  to  the 
sigmoid  cavity  by  physiological  action. 
When,  however,  the  functions  of  the  anus 
and  rectum  are  disturbed  by  chronic  in- 
flammation, etc.,  the  lower  portion  of  the 
rectum  becomes  a  more  or  less  roomy 
pouch,  a  receptacle  for  feces  and  liquids ; 
and  instead  of  being  physiologically  empty 
it  becomes  pathologically  distended,  the 
result  of  spasmodic  action  or  of  more  or 

less  permanent  stricture  of  the  sphincter 

24 


Inter-Dependence  of  Organs 

ani.     See  illustration  in  my  book  entitled 
How  to  Become  Strong  (page  14). 

The  putrid  fecal  mass  of  solid  and  liquid 
contents  accumulated  in  the  artificial  res- 
ervoir at  the  end  of  the  intestinal  sewer, 
is  one  of  the  most  common  and  serious 
pathogenic  (disease-producing)  and  pyo- 
genic (pus-producing)  sources,  which,  by 
auto-infection,  afflict  man  from  infancy  to 
old  age.  Here — in  the  dilated  and  ob- 
structed sewer — the  ptomain  and  leuco- 
main  class  of  poisons,  and  many  of  the 
poisonous  germs,  led  by  the  king  of 
morbid  disturbers,  the  bacillus  coli  com- 
munis, find  another  and  last  chance  to  be 
taken  up  by  the  absorbing  cells  of  the 
mucous  membrane  and  returned  to  the 
blood  ;  with  which  they  are  carried  to  all 
parts  of  the  body,  clogging  the  glands, 
choking  up  the  pores  and  obstructing  the 
circulation,  thereby  causing  congestion 
and  inflammation  of  the  various  organs. 
The  action  of  cathartics,  laxatives,  etc., 
fills  the  ano-rectal  cavity  with  a  watery 
solution  of  foul  substances ;  this  solution 
as 


Intestinal  Ills 

is  readily  absorbed  into  the  circulation, 
aggravating  the  auto-intoxication  (the  es- 
tablished self-poisoned  condition)  already 
existing.  Danger  does  not  end  with  the 
absorption  of  bacterial  poisons,  as  we 
have  to  reckon  with  the  deleterious  effects 
of  the  various  intestinal  gases,  resulting, 
with  rapid  augmentation  of  volume,  from 
the  putrefactive  changes  in  the  imprisoned 
feculent  matter. 

A  sphincter  ani  permanently  constricted 
or  irritable  owing  to  disease  results  in  an 
abnormal  receptacle  just  above  the  anal 
orifice  (as  shown  in  the  illustration  re- 
ferred to)  ;  and  a  constricted  and  irritable 
rectum  results  in  the  impaction  and  dilata- 
tion of  the  sigmoid  cavity,  which  is  nor- 
mally a  receptacle,  closed  at  its  lower  end 
by  circular  fibres  separating  it  (the  cavity) 
from  the  rectum  and  performing  the  func- 
tion of  a  sphincter  muscle.  The  rectal 
muscular  fibres  perform  the  office  of  a 
sphincter  for  the  sigmoid  cavity.  The 
pathological  changes  that  result  in  rectal 
impaction  of  feces  usually  extend  to  the 

26 


Inter-Dependence  of  Organs 

sigmoid  cavity.  This  cavity  is  1 1\  inches 
in  length,  shaped  in  a  double  curve  like 
an  italic  .SI  Civilized  man  should  con- 
sider the  disturbance  to  the  functional 
action  of  body  and  brain,  and  the  danger 
to  health  and  longevity  involved  in  the 
storage  of  effete  and  fetid  matter.  The 
disturbance  and  danger  are  enhanced 
when  the  tissues  of  the  sigmoid  flexure 
and  the  rectum  are  invaded  by  inflamma- 
tion. A  healthy  action  of  the  sigmoid 
receptacle  depends  on  the  rectum  (a  con- 
duit six  to  eight  inches  in  length)  ;  and  as 
it  is  the  universal  verdict  that  disease  of 
the  rectum  is  one  of  the  most  common 
maladies  that  afflict  the  human  race,  it 
must  inevitably  follow  that  the  feces  will 
be  abnormally  stored  in  the  sigmoid  cav- 
ity, occasioning  thereby  habitual  constipa- 
tion which  in  turn  brings  on  a  host  of 
functional  disturbances  throughout  the 
system. 

The  colon  is  a  receptacle  and  a  conduit 
some  three  feet  in  length  (see  ib.  p.   13) 
and   its   action   depends  upon  the  ability 
27 


Intestinal  Ills 

of  the  sigmoid  flexure  to  perform  its 
function  as  a  final  normal  receptacle  ;  and 
this  in  turn  upon  the  rectum,  which  de- 
pends on  the  sphincter  ani.  The  colon 
does  not  appear  to  possess  any  digestive 
powers,  though  it  is  capable  of  absorbing 
substances.  Its  function  is  not  only  to 
receive  and  forward  the  trifling  residue  of 
food  which  escapes  digestion  and  absorp- 
tion, but  chiefly  to  excrete,  through  its 
own  minute  glands,  the  waste  of  the 
system  coming  from  the  blood. 

The  excretion  from  these  glands  of  the 
colon  into  the  colon,  plus  the  effete  por- 
tion of  the  food  received  by  the  colon 
from  the  small  intestine,  approximate  in 
weight  from  four  to  six  ounces  in  an  adult 
person  in  twenty-four  hours ;  and  of  this 
amount  passed  75  per  cent  is  water ;  so 
that  were  the  excreta  dried  the  solid 
matter  thus  evacuated  would  not  be  found 
to  weigh  more  than  one  ounce,  or  one 
and  a  half  ounces. 


CHAPTER  IV. 

INDIGESTION,    INTESTINAL    GAS,    AND    OTHER 
MATTERS. 

WE  noted  the  fact  that  the  "  digestive 
secretions  "  in  a  man  weighing  140 
pounds  amount  to  twenty-three  pounds 
in  twenty-four  hours  ;  now  add  to  these 
the  food  and  liquids  taken  in  that  period, 
and  you  will  form  some  estimate  of  the 
work  done  in  the  human  chemical  labora- 
tory in  its  normal  and  abnormal  states. 

We  noted  further  that  substances  con- 
fined too  long  in  receptacles  decompose 
and  generate  pathogenic  poisons,  that  is, 
poisons  productive  of  disease  ;  and  that 
the  intestinal  reservoirs  are  no  exception 
to  this  law  of  putrefactive  changes.  How 
could  we  avoid  drawing  the  inference, 
therefore,  that  disease-breeding  germs, 
(generated  in  the  organism  and  hence 
called  "  autogenetic  " ),  and  their  auto- 
39 


Intestinal  Ills 

infection,  i.e.,  absorption  by  the  system,  are 
an  inevitable  consequence  of  the  undue 
retention  and  fermentation  of  the  contents 
of  these  reservoirs:  a  consequence,  in 
other  words,  of  that  intestinal  uncleanli- 
ness  commonly  called  biliousness,  con- 
stipation, indigestion. 

By  far  the  most  common  and  immediate 
source  of  autogenetic  (self-produced)  poi- 
sons and  their  auto-infection,  is  some  degree 
of  chronic  constipation  and  the  deadening, 
smothering  effects  of  constipation  on  di- 
gestion ;  an  effect  analogous  to  what  takes 
place  when  we  allow  waste  material  or 
ashes  to  bank  up  against  a  fire,  shutting 
off  its  draft.  Does  the  fire  then  continue 
to  digest  the  coal  ?  Clog  up  the  receptacle 
for  ashes  and  the  coal  grows  cold.  Dam 
up  the  colon  or  sigmoid  and  digestion  is 
disturbed,  diminished  and  debased,  as 
evidenced  by  the  local  and  general  dis- 
comfort, and  later  by  the  train  of  inevita- 
ble disorders. 

Indigestion    is   a  household  word.     It 

has  the  widest  range  of  all  the  diseases, 

30 


Poisons  and  Gases 

because  it  forms  a  part  of  almost  every 
other ;  and  some  diseases,  such  as  chronic 
catarrh  and  pulmonary  consumption,  are 
in  many  case&  produced  by  indigestion  ; 
which  in  turn  had  its  source  in  chronic 
constipation  caused  by  injury  or  inflam- 
mation of  the  lower  bowel,  as  explained 
in  our  first  chapter. 

Diminished  nutrition,  impoverished 
blood,  and  loss  of  weight  of  from  ten 
to  twenty-five  pounds,  are  the  signs  that 
indicate  the  coming  disaster  to  the  sufferer 
from  auto  -  intoxication  :  the  thoroughly 
poisoned  state  of  the  system  resulting 
from  auto-infection. 

Vessels  used  by  the  dairyman  and  by 
those  who  furnish  us  with  food  products 
and  liquids  are  kept  scrupulously  clean. 
Why  ?  Because  it  is  a  question  of  loss  of 
trade  —  of  money.  Should  these  vessels 
be  used 'when  foul  from  fermentation  or 
putrefaction  of  their  contents,  Wealth 
would  flee  from  the  coffers  of  our  purvey- 
ors, and  the  Boards  of  Health  would,  or 
rather  should,  take  a  hand  in  the  matter. 

31 


Intestinal  Ills 

And  these  same  purveyors,  by  the  way, 
why  do  they  care  more  for  Wealth  than 
for  Health,  their  own  and  ours?  But 
why  are  we  all  of  us  so  neglectful  of  Inner 
cleanliness  and  so  careful  of  Outer?  The 
receptacles  of  the  inner  man  reek  with 
augean  filth,  and  we  cleanse  them  not. 
The  immortal  fountains  of  Health  and 
Happiness  are  dammed,  blasted  and  de- 
graded by  just  this  neglect  of  our  impera- 
tive duty ;  the  duty  of  furnishing  full 
opportunity  for  the  functions  of  replenish- 
ment and  life,  by  keeping  the  sewer  passages 
clear. 

Are  a  sour  stomach  and  foul  intestinal 
canal  fit  receptacles  for  food  and  liquids  ? 
When  our  receptacles  are  in  this  condition, 
why  do  we  add  more  material  for  the 
generation  of  poisons  of  the  ptomain  and 
leucomain  classes,  and  morbid  gaseous 
elements  ?  It  has  been  demonstrated  that 
during  fermentation  an  apple  will  evolve 
a  volume  of  gas  six  hundred  times  its  own 
size.  What  folly  then  to  add  to  the  fer- 
menting mass !     Food  taken  under  such 

32 


Poisons  and  Gases 

conditions  will  produce  results  not  hard 
to  imagine. 

The  gases  that  are  commonly  found  in 
the  stomach  and  small  intestines  are  car- 
bonic acid,  nitrogen,  oxygen  and  hydro- 
gen ;  while,  besides  all  these,  sulphureted 
and  carbureted  hydrogen  are  found  in 
the  large  intestine,  causing  in  a  normal 
state  the  necessary  and  useful  distention 
of  the  alimentary  canal.  The  writer  has 
long  regarded  the  abnormal  production 
of  gaseous  substances  in  the  intestinal 
canal  from  putrefactive  changes  as  of  it- 
self not  only  a  grave  menace  to  health, 
but  as  a  condition  productive  of  morbific 
results  of  which  we  have  still  much  to 
learn.  The  more  or  less  constant  and 
excessive  distention  of  the  whole  or  even 
of  a  part  of  the  intestinal  canal  by  gases 
is  a  serious  condition,  affecting  as  it  does 
the  various  organs  of  the  body,  not  only 
through  the  absorption  of  these  gases 
into  the  general  circulation  but  also 
through  the  reflex  nervous  reaction  of 
these  organs.  It  is  astonishing  what 
33—3 


Intestinal  Ills 

amount  of  mechanical  force  is  exerted  by 
the  gases  in  the  intestinal  canal.  They 
distend  not  only  the  muscular  walls  of  the 
intestines  and  stomach  but  the  strong  ab- 
dominal walls  as  well,  until  the  clothing 
worn  has  to  be  loosened  for  ease  and 
comfort.  This  more  or  less  extreme 
mechanical  pressure  may  account  for 
many  cases  of  hernia,  prolapse  of  the 
uterus,  dislocation  of  various  organs,  dis- 
turbance of  the  circulation  of  the  blood, 
and  interference  with  the  function  of  the 
nervous  system,  as  indicated  by  its  many 
protests  in  the  way  of  aches  and  pains. 
Naval-constructor  Hobson  has  lately  de- 
monstrated the  dynamic  power  of  gas 
confined  in  bags  or  receptacles  in  raising 
battleships  ;  and  it  still  remains  for  some 
physiologist  or  pathologist  to  demonstrate 
the  morbid  dynamic  results  of  gases  con- 
fined in  the  alimentary  apparatus.  The 
deleterious  effect  of  the  abnormal  quan- 
tity of  gases  on  all  the  organs  of  the  body 
is  imperfectly  understood  at  present,  but 
will  be  better  apprehended  when  we  are 

34 


Poisons  and  Gases 

able  to  study  more  minutely  the  patho- 
genic poisons  of  the  human  system.  It  is 
known,  however,  that  a  stream  of  carbonic 
acid  gas,  or  even  of  hydrogen,  will  paralyze 
a  muscle  against  which  it  is  directed. 


35 


CHAPTER  V. 

KEY  TO   AUTO-INFECTION. 

IN  a  previous  chapter  we  stated  that  the 
average  quantity  of  fecal  discharge 
daily,  by  an  adult,  is  from  four  to  six 
ounces,  and  that  of  this  weight  75  per 
cent  is  water.  We  referred  of  course  to 
the  daily  passage  from  the  bowels  alone, 
not  including  that  from  the  bladder. 

Our  studies  have  thus  furnished  us 
with  the  key  wherewith  to  unlock  the 
secret  chambers  of  auto-infection.  What 
is  that  key?  It  is  the  discovery  that  the 
system  may  possibly  absorb  as  high  as 
three-fourths  of  this  feculent  substance  in 
the  colon  ;  that  this  absorption  is  made 
possible  by  an  obstructed  or  sluggish  in- 
testinal canal  where  disease  germs  are 
propagated  and  lodged  ;  that  these  germs, 
along  with  a  certain  amount  of  excrement, 
invade  the  tissues  by  absorption  ;  and  that 

36 


Intestinal  Auto-Infection 

we  thus  have  the  system  constantly  satu- 
rated with  poisonous  germs  and  filth,  re- 
excreted,  re-absorbed  and  re-secreted — no 
one  knows  how  many  times  —  by  the 
various  organs  of  the  body. 

That  the  importance  of  intestinal  clean- 
liness may  be  better  appreciated,  I  will 
quote  from  the  following  authors  on  the 
subjects  of  excretion,  absorption  and  cir- 
culation of  the  intestinal  fluids. 

Dr.  Murchison  states  that : 

"  From  what  is  now  known  of  the  diffus- 
ibility  of  fluids  through  animal  membranes, 
it  is  impossible  to  conceive  bile  long  in 
contact  with  the  lining-  membrane  of  the 
gall-bladder,  bile-ducts,  and  intestine,  with- 
out a  portion  of  it  (including  the  dissolved 
pigment)  passing  into  the  blood.  A  circu- 
lation is  constantly  taking  place  between 
the  fluid  contents  of  the  bowel  and  the 
blood,  the  existence  of  which,  till  within 
the  last  few  years,  was  quite  unknown,  and 
which  even  now  is  too  little  heeded.  It  is 
now  known,  says  Dr.  Parker,  that  in  vary- 
ing degrees  there  is  a  constant  transit  of 
fluid  from  the  blood  into  the  alimentary 
canal,  and  as  rapid  absorption.  The 
H 


Intestinal  Ills 

amount  thus  poured  out  and  absorbed  in 
twr.nty-foiir  hours  is  almost  incredible,  and 
of  itself  constitutes  a  secondary  or  inter- 
mediate circulation  never  dreamt  of  by 
Harvey.  The  amount  of  gastric  juice 
alone  passing  into  the  stomach  in  a  day, 
and  then  re-absorbed,  amounted  in  the 
case  lately  examined  by  Grunewald  to 
nearly  23  imperial  pints.  If  we  put  it 
at  12  pints  we  shall  certainly  be  within 
the  mark.  The  pancreas,  according  to 
Kroger,  furnishes  12^-  pints  in  twenty- 
four  hours,  while  the  salivary  glands  pour 
out  at  least  3  pints  in  the  same  time. 
The  amount  of  the  bile  is  probably  over 
2  pints.  The  amount  given  out  by  the 
intestinal  mucous  membrane  cannot  be 
guessed  at,  but  must  be  enormous.  Alto- 
gether the  amount  of  fluid  effused  into 
the  alimentary  canal  in  twenty-four  hours 
amounts  to  much  more  than  the  whole 
amount  of  blood  in  the  body  (which  is 
18  pounds  in  a  man  weighing  143  pounds)  ; 
in  other  words,  every  portion  of  the  blood 
may,  and  possibly  does,  pass  several  times 
into  the  alimentary  canal  in  twenty-four 
hours.  The  effect  of  this  continual  out- 
pouring is  supposed  to  be  to  aid  metamor- 
phosis ;  the  same  substance  more  or  less 

3& 


Intestinal  Auto-Infection 

changed  seems  to  be  thrown  out  and  re- 
absorbed until  it  be  adapted  for  the  repair 
of  tissues,  or  become  effete." 

The  reader  will  readily  perceive  how 
the  system  may  become  so  charged  that 
other  organs  of  the  body  will  vicariously 
attempt  to  play  the  part  of  a  receptacle 
and  conduit  for  the  bowel,  in  order  to  ex- 
crete and  eliminate  ancient  and  offensive 
filth  and  bacterial  poisons.  The  phenom- 
enon of  vicarious  excretion  may  occur 
through  the  kidneys,  lungs,  skin,  throat, 
nose,  vagina,  or  uterus,  thus  keeping  up 
chronic  diseases  and  discharges  that  would 
not  exist  but  for  the  chronic  constipation 
or  even  for  incomplete  action  of  the  bowels 
each  day.  Over-distention  of  the  rectum, 
sigmoid  and  colon,  due  to  the  pressure  of 
gases  and  the  impaction  of  feces,  results 
in  inflammation,  ulceration,  stricture,  ap- 
pendicitis, abscess,  strangulation,  intus- 
susception, and  abnormal  ballooning  or 
roominess  in  certain  portions  of  these  in- 
testines or  conduits.  This  roominess, 
though  it  becomes  filled  with  feces,  and 

39 


Intestinal  Ills 

often  with  liquids,  permits  of  sufficient 
space  for  even  the  daily  passage  of  feces 
without  dislodging  the  stored  contents. 
The  fact  that  there  is  a  passage  daily  de- 
ceives both  sufferer  and  medical  adviser  as 
to  the  source  of  the  poisonous  condition 
of  the  system,  and  masks  the  origin  of 
such  disorders  as  chronic  inflammation 
and  ulceration  of  the  nose,  throat,  lungs, 
stomach,  duodenum,  colon,  appendix  ver- 
miformis,  uterus,  bladder,  kidneys  and 
edema  of  the  les^s.  But  these  evidences  of 
auto-infection  are  generally  preceded  and 
accompanied  by  a  general  loss  of  vitality 
and  weight,  by  anemia,  by  a  lowering  of 
the  resisting  power  of  the  organism — all 
of  which  produce  a  fit  soil  for  the  various 
diseases  to  which  flesh  is  heir.  As  soon 
as  the  system  becomes  saturated  with 
bacteria  and  effete  matter,  auto-intoxica- 
tion results,  in  which  condition  there  is 
but  little  or  no  store  of  vitality  for  resist- 
ance, reaction  and  recuperation. 

Dr.    Bright    has    recorded    several    in- 
stances of  fecal  accumulation  in  the  colon 

40 


Intestinal  Auto-Infection 

mistaken  for  enlargement  of  the  liver  and 
for  malignant  tumors.  In  one  of  the 
cases  there  was  jaundice  which  disap- 
peared after  free  evacuation  of  the  bowels. 
Frerichs  also  relates  a  case  where  enlarge- 
ment from  fecal  accumulation  was  at  first 
ascribed  to  a  pregnant  uterus,  and  subse- 
quently, on  the  supervention  of  deep 
jaundice,  to  an  enlarged  liver,  but  in 
which  purgatives  dispelled  the  patient's 
anxiety  about  a  diseased  liver  and  at  the 
same  time  her  hopes  for  a  child. 

Dr.   N.  Chapman,  in  his  Clinical  Lec- 
tures (p.  304),  says  : 

"  The  feces  sometimes  accumulate  in 
distinct  indurated  scybala  or  in  enormous 
masses,  solid  and  compact.  Taunton, 
a  surgeon  of  London,  has  a  preparation 
of  the  colon  and  rectum  of  more  than 
twenty  inches  in  circumference  contain- 
ing three  gallons  of  feces,  taken  from 
a  woman,  whose  abdomen  was  as  much 
distended  as  in  the  maturity  of  preg- 
nancy. By  Lemazurier,  another  case  is 
reported  of  a  pregnant  woman,  who  was 
constipated  for  two  months,  from  whom, 
41 


Intestinal  Ills 

after  death,  thirteen  and  one-half  pounds 
of  solid  feces  were  taken  away,  though  a 
short  time  before  between  two  and  three 
pounds  had  been  scraped  out  of  the  rec- 
tum. Cases  are  reported  by  Dr.  Graves 
of  Dublin,  which  he  saw  in  women,  where 
from  the  great  distentions  in  certain  di- 
rections of  the  abdomen,  the  one  was 
considered  to  be  owing  to  a  prodigious 
hypertrophy  of  the  liver,  and  the  other  of 
the  ovary ;  in  the  latter  of  which  he  re- 
moved a  bucket-full  of  feces  in  two  days. 
Mr.  Wilmot  of  London  has  recently  given 
a  case  where  a  gallon  Qf  matter  was 
lodged  in  the  caecum,  and  the  intestines 
perforated  by  ulceration." 

Dr.  Pavy,  in  his  treatise  on  The  Func- 
tions of  Digestion  (p.  232),  writes: 

"  The  morbid  conditions  that  constipa- 
tion may  occasion  are  of  various  kinds. 
Under  an  undue  retention  of  fecal  matters 
within  the  colon  noxious  products  may  be 
formed  there,  and  act  as  irritants  upon 
the  mucous  coat,  setting  up  inflammation, 
followed  by  ulceration.  It  is  to  be  here 
remarked  that  fecal  matters  are  sometimes 
retained  in  the  sacculi  or  pouches  of  the 
colon,  and  may  give  rise  to  the  circum- 

42 


Intestinal  Auto-Infection 

stances  referred  to,  whilst  a  passage  exists 
along  the  centre  of  the  canal  that  shall 
permit  a  daily  evacuation  to  occur.  The 
dejections,  even,  may  be  loose  in  char- 
acter, and  still  the  same  sequence  of 
events  ensue.  From  the  irritating-  influ- 
ence  of  preternaturally  retained  feces, 
colicky  pains  are,  as  a  rule,  induced,  and 
the  ultimate  effects  may  be  such  as  to  lead 
to  the  production  of  fatal  inflammation. 

"The  effect  of  constipation  upon  the 
muscular  coat  of  the  bowel  is,  through 
distention  to  which  it  is  subjected,  to 
weaken  or  deteriorate  its  evacuating 
power.  As  the  result  of  a  great  amount 
of  distention,  like  as  happens  in  the  case 
of  the  urinary  bladder,  more  or  less  com- 
plete paralysis  is  induced.  From  the 
prolonged  retention  of  fecal  matter  ac- 
companying constipation,  excrementitious 
products  that  ought  to  be  eliminated  be- 
come absorbed  and  thereby  contaminate 
the  contents  of  the  circulatory  system. 
As  the  result  of  this  contamination,  the 
secretions  become  vitiated,  and  a  general 
disturbance  of  the  conditions  of  life  is 
produced.  The  action  of  the  liver  be- 
coming deranged,  its  eliminative  office  is 
imperfectly  discharged,  and  thus  sallow- 

43 


Intestinal  Ills 

ness  of  the  face  and  a  bilious-tinged  con- 
junctiva are  produced.  A  coated  tongue, 
foul  mouth,  loss  of  appetite,  and  other 
dyspeptic  manifestations,  accompany  the 
general  disorder  of  the  digestive  organs 
that  prevails.  The  accumulation  existing 
in  the  colon  leads  to  a  sense  of  distention 
and  uneasiness  in  the  abdomen.  The 
kidneys  vicariously  discharge  products 
that  ought  to  have  been  eliminated  by 
the  alimentary  canal.  In  this  manner 
the  urine  becomes  preternaturally  loaded. 
From  the  contaminated  state  of  the  blood 
the  functions  of  animal  life  also  become 
disturbed  ;  and  hence  the  lassitude,  debil- 
ity, headache,  giddiness  and  dejected 
spirits,  that  form  such  frequent  accompani- 
ments of  constipation.  ...  A  distended 
caecum,  colon,  and  rectum  may  also,  by 
the  pressure  exerted  upon  the  nerves  and 
vessels  of  the  lower  extremities,  be  the 
cause  of  numbness,  cramps,  pains  and 
edema  of  the  legs.  The  edema  occasioned 
by  constipation,  if  not  exclusively  confined 
to  one  side,  will  in  all  probability  be  de- 
cidedly greater  in  one  leg  than  in  the 
other." 

Case  (from  Gaz.  Mtd.  de  Paris,   July 

44 


Intestinal  Auto-Infection 

20,  1839)  :  A  woman  of  fifty  was  troubled 
with  habitual  diarrhea  and  frequent  calls 
to  urinate,  in  which  urine  could  be  dis- 
charged only  by  drops.  After  six  years  of 
suffering  and  unsuccessful  use  of  remedies, 
she  was  examined  for  the  first  time  per 
anum,  and  an  accumulation  of  fecal  matter 
discovered,  forming  a  mass  the  size  of  an 
infant's  head.  This  was  removed  and 
found  to  weigh  four  pounds.  She  then 
got  well. 


CHAPTER  VI. 

HOW  AUTO-INFECTION  AFFECTS   THE  GASTRIC 
DIGESTION,  AND   VICE   VERSA. 

FREDERICK  the  Great  said  that  all 
culture  comes  through  the  stomach. 
This  saying"  emphasizes  pithily  the  de- 
pendence of  psychology  upon  physiology. 
The  stomach  with  the  intestines  is  certainly 
the  source  from  which  every  portion  of  the 
body  receives  its  nourishment  and  most 
of  its  diseases.  The  physiological  plus 
and  minus  processes  leave  their  reflex 
on  the  mind. 

Prof.  Ch.  Bouchard,  in  his  lectures  on 
Auto-Intoxication  (Oliver's  trans.,  p.  14), 
says  :  "  The  organism  in  its  normal,  as  in 
its  pathological  state,  is  a  receptacle  and 
a  laboratory  of  poisons.  Amongst  these 
some  are  formed  by  the  organism  itself, 
others  by  microbes,  which  either  are  the 
guests,    the    normal    inhabitants    of     the 

46 


Functional  Disturbances 

intestinal  tube,  or  are  parasites  at  second- 
hand, and  disease  producing." 

In  the  preceding  chapters  we  have  men- 
tioned some  of  the  most  common  cases 
of  retention  of  excreta  in  the  rectum, 
sigmoid  cavity,  colon,  cecum,  duodenum 
and  stomach,  and  how  the  consequent 
foul  conditions  often  resulted  in  diarrhea. 
Auto-infection  impairs  the  functions  of 
every  organ  in  the  body,  by  clogging  the 
pores  with  poisons  and  filth.  By  the  trans- 
fer of  disease  germs  from  one  infected, 
that  is,  tainted,  contaminated  part  of  the 
body  to  parts  that  were  free  from  infec- 
tion, the  kidneys,  mucous  membrane  and 
skin  receive  these  unnatural  products,  and 
their  functions  are  disturbed  thereby.  The 
disturbance  of  the  various  organs  through- 
out  the  system  sets  up  such  a  multiplicity 
of  symptoms  that  one  gets  the  impression 
of  a  pandemonium — a  veritable  council- 
hall  of  evil  spirits.  The  visitation  is 
omnipresent.  Infliction,  misery,  are  every- 
where. The  taint  of  auto-generated  in- 
testinal   morbific    products,    carried    and 

47 


Intestinal  Ills 

communicated  to  the  remotest  parts, 
manifests  itself  now  here  now  there  as  if 
it  were  a  local  trouble,  and  it  is  difficult 
therefore,  nay,  impossible,  to  classify  scien- 
tifically the  symptoms  of  auto-infection. 
A  classification,  though  necessarily  im- 
perfect, will  aid  in  the  diagnosis  and 
treatment  of  the  various  abnormal  condi- 
tions of  the  stomach  and  intestines,  that 
is,  of  mal-digestion.  The  sympathy,  good 
understanding  and  responsiveness  between 
the  brain  and  the  digestive  apparatus  are 
so  close  and  intimate  that  the  physician 
must  take  into  consideration  the  inter- 
relationship of  these  organs  before  decid- 
ing which  one  is  reporting  reflex  nervous 
symptoms,  and  which  direct  symptoms. 
Plutarch  says  in  one  of  his  essays  :  "  Should 
the  body  sue  the  mind  before  a  court 
judicature  for  damages,  it  would  be  found 
that  the  mind  had  been  a  ruinous  tenant 
to  its  landlord."  The  digestive  apparatus 
is,  or  should  be,  a  farm  for  the  mind, 
but   unfortunately  it  usually  has  to  wait 

twenty  or  more  years  before  the  tenant 

4s 


Functional  Disturbances 

understands  how  to  cultivate  it  for  the 
uses  of  his  intellectual  and  esthetical  life. 

I  have  referred  to  the  fact  that  the 
most  common  causes  of  constipation,  in- 
digestion and  other  foul  conditions  of  the 
alimentary  canal  favorable  to  the  produc- 
tion of  autogenetic  poisons  and  their 
auto-infection,  are  such  common  and 
every-day  matters,  so  familiar  to  almost 
every  one  that  the  victim,  the  parents 
and  the  physician  feel  no  alarm  of  the 
coming  danger  for  years.  During  these 
ignorant  and  innocent  years  the  poison 
and  filth  were  being  absorbed,  infecting 
the  system  with  their  morbific  taint  and 
lowering  the  quality  of  the  blood  and 
lessening  its  quantity,  producing  the  state 
known  as  anemia.  Associated  with  pro- 
gressive anemia  is  mal-assimilation,  im- 
proper nutrition,  ebbing  of  the  nervous 
and  vital  forces  and  the  lessening  of  the 
secretory,  excretory  and  digestive  powers. 
By  the  time  the  poor  victim  is  weighing 
fifteen  to  twenty-five  pounds  less  than  he 
ought  to  the  symptoms  of  ill-health  are 

49 — » 


Intestinal  Ills 

sufficiently  alarming  to  compel  the  sufferer 
to  seek  medical  aid  for  disease  of  the 
stomach,  bowels,  liver,  kidneys,  lungs,  etc. 
Slow  digestion  is  perhaps  the  most  com- 
mon form  of  functional  disturbance  of  the 
stomach,  due  to  an  insidious  auto-infection 
for  years.  The  eyes  and  the  skin  begin 
to  show  the  effect  of  the  poisonous  infec- 
tion. The  skin  becomes  dry,  pale  and 
muddy  in  color ;  has  more  or  less  annoy- 
ing eruptions,  and  exhibits  a  jaundiced 
appearance.  The  body  is  ill  nourished, 
the  nervous  system  depressed,  the  blood 
impoverished,  the  memory  failing,  the  gen- 
eral appearance  languid,  irritable,  anxious. 
What  a  household  picture  this  is  to  every 
one  of  the  human  family  !  But  let  us  fill 
it  out  somewhat  more  fully.  Note  how 
the  undue  delay  of  food  in  the  stomach 
occasions  a  sense  of  weight  and  oppres- 
sion, the  feeling  beginning  about  an  hour 
after  a  meal  and  continuing  for  hours, 
sometimes  attended  with  fermentation  and 
sometimes  without  it.  At  times  there  is 
a  feeling  of  drowsiness  due  to  the  absorp- 

50 


Functional  Disturbances 

tion  of  an  excessive  amount  of  the  gases 
which  distend  the  stomach  and  bowels, 
and  this  absorption  is  accompanied  by 
pains  in  the  stomach,  head,  between  the 
shoulders  and  in  the  region  of  the  heart. 
Sleep  is  disturbed  by  dreams,  or  one  is 
awakened  with  a  feeling  of  numbness  and 
palpitation  of  the  heart.  At  times  the 
urine  is  scanty,  strongly  acid  or  high-col- 
ored. The  tongue  is  more  or  less  foul, 
with  white  or  creamy  coating.  Now  and 
then  tasteless  or  saltish  eructations  occur. 
The  appetite  may  be  too  good,  or  there 
is  no  appetite  at  all.  Note  the  careworn 
expression,  the  wondering  what  to  eat, 
what  to  drink  or  what  remedy  to  take. 
So  between  much  worse  and  some  better, 
the  trouble  continues — both  of  body  and 
mind. 

Indigestion,  however,  with  undue  for- 
mation of  acids  proper,  or  acids  unna- 
tural, to  the  stomach,  is  a  much  more 
annoying  affliction  than  slow  digestion. 
The  sufferer  from  indigestion  may  be  de- 
bilitated, anemic,  may  have  a  general 
51 


Intestinal  Ills 

want  of  tone  ;  or  he  may  be  a  more  or 
less  vigorous  and  plethoric  person.  In 
some  cases  flatulence  is  very  troublesome. 
But  the  most  usual  symptoms  are  heart- 
burn, acid  eructations  that  produce  burn- 
ing sensations,  sour  taste  at  intervals  or 
constantly  in  the  mouth,  setting  the  teeth 
on  edge.  In  the  more  vigorous  or  ple- 
thoric sufferers  a  gouty  diathesis  may  ex- 
ist, which  may  result  in  a  tendency  to 
inflammation,  bringing  on  neuralgia,  rheu- 
matism, gout,  etc.  Tongue  more  or  less 
foul ;  uric  acid  in  the  system  ;  confusion 
in  the  mind  ;  headaches ;  pains  in  the 
loins,  legs  and  feet ;  in  fact,  more  or  less 
shifting  pains  everywhere  :  these  are  the 
common  exhibits  of  indigestion.  On  the 
whole,  the  sufferer  is  a  victim  to  an  irri- 
table body  and  a  fretful  mind,  necessitat- 
ing the  cultivation  by  him  of  patience  and 
the  effort  to  be  agreeable. 

Besides  the  symptoms  mentioned,  in- 
digestion may  also  be  accompanied  by 
gastric  pain  or  by  uneasiness  at  the  pit 
of  the  stomach.     It  may  be  a  sense   of 

52 


Functional  Disturbances 

fulness  or  tightness,  or  a  feeling  of  dis- 
tention or  weight,  or  again,  a  feeling  of 
emptiness,  goneness  or  sinking.  Now 
and  then  there  are  burning,  tearing,  gnaw- 
ing, dragging  sensations  under  the  breast- 
bone ;  and  there  is  a  general  complaint  of 
a  capricious  appetite,  heartburn,  vomiting, 
nervous  headache,  neuralgia  and  cold  ex- 
tremities. Other  symptoms  are  pain  from 
lack  of  food  at  the  proper  hour,  or  from 
food  taken  at  the  improper  time  ;  both  of 
which  practices  may  be  followed  by  flatu- 
lency, occasioning  a  swollen,  drum-like 
condition  of  the  stomach  and  abdomen  ; 
the  body  of  the  tongue  will  be  coated 
white,  while  the  edges  will  present  a 
redder  appearance  than  in  health. 

Impaired  digestion  with  nervous  symp- 
toms— in  which  the  morbid  sensibility  of 
the  mind  is  apparently  the  greatest — is 
called  hypochondria.  This  class  of  suf- 
ferers, whose  bodily  and  mental  ills  and 
morbid  fears  are  so  chaotically  interwoven, 
are  deserving  of  much  consideration.  So 
numerous  are  their  fears  and  so  fertile 

53 


Intestinal  Ills 

are  their  reasons  for  the  many  changes 
they  arbitrarily  make  in  their  efforts  to 
get  well  or  keep  from  getting  worse,  so 
obstinately  sure  are  they  of  being  always 
ricjht — that  we  can  but  orive  them  our 
sincerest  pity. 

In  some  cases  the  functional  troubles 
of  the  stomach  and  mind  are  aggravated 
by  disease  of  the  pelvic  organs,  which 
adds  to  the  depression  of  the  mind  through 
nervous  sympathy  with  the  abdominal 
organs. 

Dr.  Cullen  says  on  this  point :  — 

"In  certain  persons  there  is  a  state  of 
mind  distinguished  by  a  concurrence  of 
the  following  circumstances  :  a  languor,  a 
listlessness,  or  want  of  resolution  and  ac- 
tivity with  respect  to  all  undertakings  ;  a 
disposition  to  seriousness,  sadness  and 
timidity  as  to  all  future  events ;  an  appre- 
hension of  the  worst  or  most  unhappy 
state  of  them  ;  and  therefore,  often  upon 
slight  grounds,  an  apprehension  of  great 
evil.  Such  persons  are  particularly  atten- 
tive to  the  state  of  their  own  health,  to 
every  smallest  change  of  feeling  in  their 

54 


Functional  Disturbances 

bodies  ;  and  from  any  unusual  feeling,  per- 
haps of  the  slightest  kind,  they  apprehend 
great  danger  and  even  death  itself.  In 
respect  to  all  these  feelings  and  appre- 
hensions, there  is  commonly  the  most  ob- 
stinate belief  and  persuasion."  (Quoted 
in  Leared,  On  Imperfect  Digestion,  p.  106.) 


5S 


CHAPTER  VII. 

HOW    AUTO-INFECTION    AFFECTS    INTESTINAL 
DIGESTION,  AND  VICE  VERSA. 

INTESTINAL  indigestion  is  a  more 
common  form  of  functional  disturbance 
than  is  gastric  indigestion.  It  is  a  well 
established  fact  that  the  greater  portion  of 
the  digestive  work  is  done  beyond  the 
stomach,  in  the  duodenum,  by  the  hepatic 
and  pancreatic  fluids.  The  duodenum — 
very  properly  called  the  second  stomach — 
has  none  of  the  peculiar  characteristics 
of  a  receptacle  that  receives  crude  sub- 
stances— the  office  of  the  stomach.  Much 
greater  sensitiveness  characterizes  the 
digestive  canal  than  the  stomach  ;  which 
is  accounted  for  by  the  fact  that  a  net- 
work of  nerves,  forming  the  sympathetic 
system,  surrounds  the  bowels.  The  symp- 
toms of  intestinal  indigestion  are  not 
always  clearly  defined  and  distinguishable 

56 


Impaction  and  Inflammation 

from  gastric  indigestion,  especially  as  the 
two  are  frequently  associated. 

The  cecum,  more  than  any  other  por- 
tion of  the  digestive  canal,  resembles  the 
stomach,  and  it  secretes  an  acid,  albumin- 
ous fluid  having  considerable  solvent 
properties.  It  is  to  be  observed  that  as 
the  cecum  is  only  three  inches  in  length 
and  two  and  a  half  in  diameter,  and  as  its 
contents  are  necessarily  propelled  in  oppo- 
sition to  gravity,  a  slight  casualty  will 
hinder  or  obstruct  the  upward  movement 
of  the  pultaceous  mass  of  the  effete  in- 
gesta.  The  turning  point  in  the  ascend- 
ing colon  affords  another  ready  hindrance 
to  the  upward  and  onward  movement  of 
this  mass  ;  and  the  gases  and  ancient 
feces  beyond  the  turn  conduce  to  further 
sluggish  peristalsis,  bringing  about  more 
or  less  obstruction  and  reflex  irritation  of 
the  remaining  length  of  intestinal  canal. 
Undue  retention  of  the  contents  of  the 
cecum,  and  the  disturbance  and  obstruc- 
tion of  the  duodenum  by  the  pressure  in- 
cident to  the  distention  of  the  colon  with 

57 


Intestinal  Ills 

feces  and  gases,  lead  to  congestion,  in- 
flammation and  occasionally  to  ulceration 
of  the  mucous  membrane  in  various  parts 
of  the  intestinal  tube. 

This  condition  of  affairs  increases  the 
occlusion  (closing)  of  the  bowels,  but 
makes  very  easy  indeed  the  entrance  and 
propagation  of  micro-organisms  in  the 
sub-mucous  coat  of  the  intestine.  The 
conditions  are  now  ripe  and  rife  for 
auto-infection.  Which  of  the  following 
microbes  are  the  most  active  agents 
of  progressive  auto-infection  :  the  strep- 
tococcus lanceolatus,  the  bacterium 
pyogenes,  the  bacillus  subtilis,  the  sta- 
phylococci, the  bacterium  coli  commune  ? 
They  all  play  a  part  in  the  game,  redu- 
cing the  body  in  time  to  a  charnel-house. 
Or  are  such  substances  as  putrescein,  ca- 
daverin,  skatol  or  indol — which  are  de- 
rived through  chemical  change  in  the 
putrescent  mass  —  contributors  to  the 
spread  of  the  poisonous  taint  throughout 
the  system  ?  Any  single  one  or  a  group 
of  the  fifty  or  more  bacterial  poisons  may 

58 


Impaction  and  Inflammation 

be  the  responsible  agents  in  the  ensuing 
auto-infection.  Chemical  analysis  of  the 
gases  resulting  from  decomposition  re- 
veals oxygen,  nitrogen,  hydrogen,  car- 
bonic acid,  protocarbonated  hydrogen  and 
sulphureted  hydrogen,  ammonia,  and  sul- 
phate of  ammonia.  Leucin,  tyrosin,  lithic 
acid,  lithates,  xanthin,  cystin,  keratin,  sul- 
phureted hydrogen,  etc.,  are  deposits  in 
the  urine  and  are  signs  of  the  derangement 
of  the  intestinal  canal  and  liver.  The  ex- 
ternal symptoms  observed  are  the  follow- 
ing :  the  tongue  is  large,  pale,  flabby  and 
indented  by  the  teeth  at  the  edge  of  the 
anterior  third,  while  its  surface  is  white 
and  the  papillae  often  enlarged  ;  the  appe- 
tite may  be  excellent,  though  there  is 
great  functional  derangement  of  the  liver 
with  lithemia,  so  that  the  sufferer  is 
tempted  to  eat  what  he  knows  from  ex- 
perience will  disagree  with  him  ;  a  bitter 
coppery  taste  in  the  mouth,  due  to  tauro- 
cholic  acid — a  common  symptom  of  lithe- 
mia or  of  imperfect  oxidation  of  albumen  ; 
emaciation,  fatigue,  depression,  headache, 

59 


Intestinal  Ills 

buzzing  in  the  ears  and  deafness,  disturb- 
ance of  sight,  loss  of  memory,  faintness 
and  vertigo,  very  marked  in  some  cases  ; 
sometimes  tenderness  and  pain  under  the 
cartilages  of  the  right  ribs  ;  the  fretting 
of  the  sensitive  surface  of  the  bowels  by 
imperfectly  digested,  semi-putrescent  food, 
resulting  sometimes  in  convulsions,  coma, 
paralysis,  or  in  fetid  diarrhea  of  an  acid 
character  producing  a  burning  sensation 
or  pain  of  the  anus  when  the  discharges 
are  being  passed  ;  rumbling  and  twisting 
sensations  in  the  region  of  the  navel  oc- 
curring  with  flatulency,  and  occasionally 
colicky  pains  which  at  times  are  so  se- 
vere as  to  simulate  poisoning. 

In  some  people  certain  articles  of  food, 
without  being  either  toxic  or  putrid,  in- 
duce indigestion  and  the  production  of 
microbes  in  quantity  amounting  to  one 
third  of  fecal  dejections.  Prof.  Ch. 
Bouchard    says  : 

"The  consequence  of  this  development 
of  acid  in  the  whole  length  of  the  diges- 
tive  tube   is  an   inflammatory   condition. 

60 


Impaction  and  Inflammation 

We  notice  catarrh  of  the  stomach,  ulcera- 
tive gastritis,  to  which  patients  often 
succumb  after  twenty-five  years  of  bad 
stomach  ;  these  are  the  false  cancers,  as 
they  are  called,  or  malignant  gastritis 
without  tumor.  The  large  intestine  is 
inflamed  ;  around  the  fecal  matter  are  seen 
glairy  secretions  and  sometimes  blood 
(membranous  enteritis)."  (Op.  cit.,  p.  159.) 

In  chronic  inflammation  of  the  rectum 
and  colon  there  is  more  or  less  dis- 
charge of  mucous,  and  in  some  cases  of 
membranous,  desquamation,  with  yellow 
or  bloody  mucus.  The  shreds,  cords  or 
complete  tubular  casts  are  discharged 
constantly  or  at  varying  intervals.  The 
quantity  and  character  often  alarm  the 
sufferer.  The  discharge  is  nothing  less 
than  a  thick,  tenacious  mucus  that  had 
formed  a  thin  coating  on  the  inflamed 
mucous  membrane,  and  become  exfoli- 
ated in  casts  or  thin  shreds — the  result 
of  many  years  of  morbid  intestinal  exag- 
gerated action. 

Microscopical  examination  of  the  des- 
61 


Intestinal  Ills 

quamated  intestinal  membrane  and  mu- 
cus from  a  man  forty  years  of  age,  revealed 
the  following-  products  :  crystals,  mostly 
complete  ;  incomplete  phosphates,  very 
numerous  ;  mucous  shreds  in  abundance  ; 
fat  globules  and  granules,  numerous  ;  anal 
epithelia  ;  red  blood  globules,  few  ;  con- 
nective tissue,  scanty  ;  pus  corpuscles, 
very  few  ;  margaric  acid  and  detritus 
(substances  resulting  from  the  destruction 
or  wearing  away  of  the  part)  ;  undi- 
gested material,  mostly  cellulose  ;  lepto- 
thrix  threads,  micrococci ;  and  the  bacillus 
coli  communis.  Diagnosis  :  foul,  undi- 
gested material,  due  to  a  chronic  inflam- 
mation of  the  lower  intestinal  tract.  The 
microscopical  examination  of  mucus  and 
desquamated  membrane  from  a  woman 
sixty-five  years  of  age,  disclosed  that  she 
was  suffering  from  proctitis  and  colitis. 
She  wrote  :  "  Please  tell  me  how  long 
this  mucous  discharge  must  continue.  I 
am  alarmed  at  the  quantity  of  membrane, 
cords,    casts,  etc.,    in    my  excreta,   and   I 

think  that  if  this  process  goes  on  much 

6a 


Impaction  and  Inflammation 

longer  there  will  soon  be  no  bowels  left 
to  purify."  This  letter  was  written  some 
weeks  after  contracting  a  severe  cold, 
which  accounts  for  the  unusual  amount  of 
exfoliation  and  mucus.  The  sample  she 
sent  contained  a  large  quantity  of  mucus, 
both  threads  and  corpuscles  ;  with  a  mod- 
erate number  of  epithelial  scales,  partly 
anal  and  partly  intestinal.  Pus  corpus- 
cles were  present  in  small  numbers  ;  also 
vegetable  fibres,  fat,  starch,  muscle  fibres 
and  cellulose — the  remains  of  undigested 
material.  In  the  membranes  themselves 
no  micro-organisms  were  found ;  in  the 
pieces  containing  undigested  material  the 
bacillus  coli  communis  was  found  as  well 
as  micrococci,  and  the  bacilli  of  putrefac- 
tion (secondary  formation)  were  seen. 


63 


CHAPTER  VIII. 

THE  CAUSE  OF    CONSTIPATION  AND   HOW   WE 
IGNORANTLY   TREAT   IT. 

ONE  of  the  best  preparations  for  active 
life  is  a  first-class  intestinal  canal. 

"  An  old  Scotch  physician,"  says  Sir 
Astley  Cooper,  "for  whom  I  had  a  great 
respect  and  whom  I  frequently  met  in 
consultation,  used  to  say  to  me  as  we  were 
about  to  enter  our  patient's  room  together, 
'  Weel,  Misther  Cooper,  we  ha'  only  twa 
things  to  keep  in  meend,  and  they  '11  serve 
us  for  here  and  herea'ter ;  one  is  au'ways 
to  hae  the  fear  o'  the  Laird  before  our 
e'es,  that  '11  do  for  herea'ter ;  and  th' 
t'other  is  to  keep  our  boo'els  au'ways  open, 
and  that'll  do  for  here.'" 

A  person  whose  mind  is  devoted  to  the 
realization  of  ideals,  and  whose  body  has 
a  set  of  bowels  that  perform  the  act  of 

c4 


Diagnosis  and  Treatment  Wrong 

defecation  twice  every  twenty-four  hours, 
is  doubly  prepared  for  a  useful  life. 

"  If  thou  well  observe 

In  what  thou  eat'st  and  drink'st,  seek  from  thence 

Due  nourishment,  not  gluttonous  delight, 

Till  many  years  over  thy  head  return  : 

So  may'st  thou  live,  till  like  ripe  fruit  thou  drop 

Into  thy  mother's  lap,  or  be  with  ease 

Gathered,  not  harshly  plucked,  for  death  mature." 

Milton's  advice  in  poetic  lines  is  all 
very  well  for  those  who  have  escaped 
chronic  inflammation  of  the  lower  bowels, 
an  ailment  common  and  troublesome  even 
under  the  very  best  dietetic  regulations. 

Inflammation  having  once  penetrated 
the  circular  and  longitudinal  muscular 
fibres  or  bands  of  a  section  of  the  intes- 
tine, all  hope  of  a  comfortable  existence  is 
at  an  end,  for  such  inflammation  will  brinof 
on  constipation  and  constipation  nervous 
misery.  It  is  inevitable  that  inflamma- 
tion should  determine  this  outcome  since 
it  induces  spasmodic  contraction  of  the 
muscular  walls  of  the  tube,  lessening  the 
bore  or  closing  the  portion  of  the  canal 
invaded.  Plastic  infiltration  takes  place 
65-5 


Intestinal  Ills 

in  the  walls  of  the  gmt,  thickening  and 
binding;  them  together;  or,  if  the  inflam- 
mation  be  of  a  simple  catarrhal  or  atrophic 
nature,  the  plastic  infiltration  will  more 
or  less  bind  the  circular  muscular  bands 
of  the  gut  together  in  their  abnormally 
contracted  state  !  The  presence  of  feces 
and  eases  above  the  zone  of  the  disease 
will  increase  the  irritation  and  contraction 
of  the  affected  portion  of  the  intestine. 
Consequent  upon  these  changes  wrought 
by  inflammation,  gases  and  excrementi- 
tious  material  are  perforce  imprisoned  in 
the  intestine,  inducing  constipation,  foul 
fermentation,  flatulency,  diarrhea,  indiges- 
tion, nausea,  loss  of  appetite,  sick  head- 
ache and,  in  fine,  autogenetic  poisons, 
the  source  of  auto-infection,  ending  in 
auto-intoxication,  the  chronic  poisoned 
condition  of  the  system. 

Since  the  most  common  cause  of  chronic 
constipation,  internal  sluggishness  and  un- 
cleanliness,  is  known,  too  much  cannot  be 
said  in  condemnation  of  the  wide-spread 
abuse   of   "  liver  and   atony    persuaders " 

66 


Diagnosis  and  Treatment  Wrong 

and  the  use  of  irritating  suppositories  and 
dilating  bougies,  candles,  etc.  The  numer- 
ous and  various  drastic  purgative  nos- 
trums—  which  literally  fill  our  medical 
literature — and  the  universal  demand  for 
them,  are  evidence  of  this  very  common 
disease,  which  disease  is  rendered  worse 
by  the  drugs  taken  for  the  relief  of  a  foul 
intestinal  alveus.  An  abnormal  amount 
of  watery  secretion  is  forced  by  the  drug 
into  the  foul  canal,  to  mix  there  with  its 
contents,  of  which  the  major  portion  is 
retained  and  re-absorbed  into  the  system. 
And  to  make  the  bad  condition  and  treat- 
ment worse,  all  such  sufferers,  as  a  rule, 
drink  very  little  water,  some  scarcely 
any. 

The  demand  for  an  irritating  stimulus 
to  "open  the  bowels"  (the  exciters  con- 
tribute to  close  them)  is  largely  due  to 
the  popular  error  in  thinking,  "  I  can 
treat  my  own  bowels  quite  as  well  as  the 
doctor,  if  not  better."  No  intelligent 
person  would  think  of  stimulating  and 
irritating  daily  an  inflamed  region  of  tissue 
67 


Intestinal  Ills 

on  the  outer  portion  of  the  body  ;  yet 
this  is  precisely  what  intelligent  persons 
do  when  they  habitually  use  liver  and 
peristaltic  persuaders.  The  primary  dis- 
ease in  the  lower  bowels  and  the  conse- 
quent symptoms  are  gradually  aggravated 
as  the  "  physic  "  habit  is  formed. 

As  in  the  case  of  opium  fiends  and 
drunkards,  so  with  habitual  cathartic  dru£- 
users,  should  they  be  suddenly  deprived 
of  the  accustomed  artificial  stimulus  and 
irritant  they  become  absolutely  miserable, 
mentally  and  physically.  It  is  a  well- 
known  physiological  fact  that  every  arti- 
ficial stimulation  of  the  intestines  is 
followed  by  a  corresponding  loss  of  vital- 
ity and  reaction.  Now  that  the  almost 
universal  cause  of  undue  retention  of  foul, 
effete  matter  has  been  ascertained,  it  is 
important  to  communicate  to  the  world  at 
large  the  best  means  of  cleansing  the 
bowels  without  increasing  the  local  pri- 
mary disease  and  its  annoying  symptoms. 

That  external  physical  cleanliness  is 
next  to  godliness  is  an  apt  proverb.   That 

68 


Diagnosis  and  Treatment  Wrong 

internal  physical  cleanliness  is  nearer  to 
godliness  no  one  will  deny. 

Water  is  a  universal  solvent  and  thera- 
peutic agent  and  is  therefore  indispensa- 
ble in  the  cleansing  and  purifying  of  the 
integument  and  mucous  membrane  of  the 
body.  A  large  quantity  of  water  is  neces- 
sary to  carry  on  the  functions  of  the  ani- 
mal economy.  Water  enters  every  cell 
and  fibre  of  the  living  organism,  aiding  in 
nutrition  and  in  the  elimination  of  worn- 
out  tissues  which  if  retained  turn  into 
poisons. 

It  is  really  not  an  intelligent  but  rather 
a  barbarous  practice  to  prescribe  liver 
and  intestinal  exciters  for  the  purpose  of 
throwing  into  the  alimentary  tract  a  suffi- 
cient quantity  of  watery  excretions  to 
"  cleanse  itself "  ;  to  succeed  they  must 
first  soften  and  liquefy  the  dry,  hardened 
feces  and  scybalous  masses  (little  ancient, 
bullet-like  formations)  imprisoned  above 
an  inflamed  and  fevered  lower  bowel,  even 
colon. 

Normal  feces  consist  of    75   per   cent 

69 


Intestinal  Ills 

water ;  and  when  unduly  retained  in  the 
colon  much  of  this  fetid  percentage  is 
absorbed  into  the  system.  Then  drugs 
are  prescribed  to  liquefy  the  hardened 
putrid  remnant  and  absorption  begins 
again  :  a  fact  very  shocking  to  a  sensitive, 
even  sensible,  person. 


70 


CHAPTER   IX. 

CURES  FOR  CONSTIPATION  :   "  FEARFULLY  AND 
WONDERFULLY   MADE." 

DISEASES  of  the  anus  and  rectum 
are  very  common,  very,  numerous 
and  of  very  critical  consequences.  This 
is  especially  true  of  the  disease  of  chronic 
inflammation,  one  of  whose  symptoms  is 
piles  or  hemorrhoids.  In  the  writings  of 
the  early  Greek  and  Roman  physicians 
will  be  found  minute  descriptions  of  the 
latter  disorder.  But  on  the  whole,  the 
most  important  symptom  of  chronic  in- 
flammation of  the  lower  bowel,  and  the 
most  far-reaching  in  its  morbific  results, 
is  that  protean  monster,  chronic  consti- 
pation. It  deranges  more  lives,  from 
infancy  to  old  age,  than  any  other  patho- 
logical condition  that  can  be  named. 

For  the  cause  and  cure  of  that  mere 
symptom  of  a  disease,    constipation,  the 

71 


Intestinal  Ills 

so-called  scientific  physicians,  from  the 
early  history  of  medication  to  the  present 
time,  have  had  one  immutable  theory  as 
to  the  leading  cause,  and  one  grand  motto 
as  to  the  "  safe  and  sure "  cure.  They 
have  always  prescribed  remedies  for  this 
malady  on  the  theory  of  portal  congestion 
and  hepatic  derangement,  and  hence 
their  supreme  motto:  "Physic!  Physic ! / 
Physic  /  /  /  " 

The  layman  naturally  adopted  the  the- 
ory and  the  motto  of  his  medical  advisers  ; 
hence  in  his  self-medication  and  also  un- 
der advice  he  consumes  such  vast  quanti- 
ties of  purgative  nostrums. 

I  have  just  received  some  medical  liter- 
ature beginning  with  the  usual  salutation 
—  "  Dear  Doctor  " —  setting  forth  a  new 
and  remarkable  theory  of  the  cause,  and 
an  original  motto  for  the  cure,  of  consti- 
pation. Its  authors  have  discovered  that 
the  "rectal  nerve-tissues"  are  hungry, 
torpid,  anemic,  and  to  overcome  the 
"atony"    they   must   be    "Fed/   Fed// 

Fed/  /  /" 

72 


Theories  and  Medication 

"  The  greatest  of  physical  ills  in  Amer- 
ica," we  are  informed,  "  is  digestive  torpor 
or  semi-paralysis,  originally  induced  by  a 
kind  of  starvation  of  the  intestinal  nerve- 
tissues.  One  of  its  most  prevalent  forms 
is  constipation,"  caused  by  "  local  torpor 
or  semi-paralysis,  dependent  upon  an 
anemic  condition  of  the  nerve-tissues  of 
the  rectal  region."  By  "  feeding  directly  " 
the  limpid,  bedraggled  rectum  and  colon, 
they  receive  their  "  appropriate  nutriment, 
by  which  comes  added  vigor," — the  nutri- 
ment the  stomach  and  the  rest  of  the  sys- 
tem had  failed  to  furnish  on  account  of 
constipation,  excessive  fermentation,  in- 
digestion and  auto-infection. 

To  overcome  this  "  atony  "  of  two  or 
more  feet  of  the  lower  bowel,  a  little 
"  nutritious  "  suppository,  weighing  twenty 
grains,  is  a  "  specific."  It  is  claimed  to 
cure  chronic  auto-infection  and  the  spas- 
modic occlusion  of  the  lower  bowel !  The 
excessive  activity  of  all  the  region  invaded 
by  the  chronic  inflammation  and  the 
local    irritation  are  perpetuated  by  such 

73 


Intestinal  Ills 

"  feeding  "  instead  of  allayed  !  Does  it  not 
stand  to  reason  that  there  is  already  too 
much  activity,  and  that  when  the  irrita- 
bility reaches  a  certain  stage  diarrhea  or 
looseness  of  the  bowels  must  result  ? 
Twenty  grains  prescribed  once  a  day  to 
nourish  an  organ  (the  rectum)  six  to  eight 
inches  in  length,  and  from  one  and  a  half 
to  two  and  a  half  inches  in  diameter ! 
When  for  two  to  three  feet  the  lower 
bowel  requires  nourishment,  a  suppository 
night  and  morning  is  prescribed  !  How- 
ever, the  new  treatment  has  the  merit  of 
some  consistency  between  the  diagnosis 
and  the  treatment,  notwithstanding  both 
are  wrong. 

Chronic  inflammation  of  the  lower 
bowel  causes,  as  I  have  pointed  out,  ex- 
cessive activity  and  thereby  excessive 
nutrition  of  the  tissues  involved  in  the 
morbid  process.  But  sphincter  ani  gym- 
nastics have  been  suggested  by  some  one 
who  thinks  chronic  constipation  is  owing 
to  a  lack  of  muscular  activity  of  the  lower 
bowels  ;  and  the  following  reason  is  given  : 

74 


Theories  and  Medication 

"  Physiological  experiments  have  shown 
that  rapid  voluntary  movements  of  the 
external  sphincter  ani  and  the  levator  ani 
produce  very  active  peristaltic  movements 
of  the  large  intestine.  This  effect  is  pro- 
duced by  the  mechanical  excitement  of 
the  plexus  myentericus  of  Auerbach. 
This  curious  automatic  center  lies  be- 
tween the  two  muscular  coats  of  the 
intestine  and  controls  the  peristaltic 
movements.  A  person  suffering  from 
constipation  should  make  powerful  move- 
ments of  the  sphincter  ani,  and  of  the 
levator  ani,  in  as  rapid  succession  as  pos- 
sible, continuing  the  exercise  for  three 
or  four  minutes  or  until  the  muscles  are 
fatigued.  The  time  chosen  for  this  exer- 
cise should  be  either  before  breakfast  or 
an  hour  after  breakfast,  according-  to  the 
natural  habit  of  the  individual  in  respect 
to  the  evacuation  of  the  large  intestines." 

There  are  surgeons  who  recommend 
stretching  and  paralyzing  the  external 
sphincter  muscle ;  and  if  they  are  correct 
in  their  diagnosis  and  treatment,  those 
who  prescribe  bile-bouncers,  and  those  who 
prescribe    "  nutrient    stippositories"    and 

75 


Intestinal  Ills 

those  who  prescribe  the  use  of  rttbber 
bougies  and  candles,  should  call  a  conven- 
tion (to  meet  in,  say,  New  York  City)  to 
discuss  the  subject  and  see  if  they  can- 
not agree  to  inform  the  people  that  con- 
stipation is  a  sign  of,  or  a  factor  in,  the 
evolution  of  the  human  race.  Those  who 
believe  in  the  gymnastics  of  man's  ears 
and  of  his  sphincter  ani  and  the  thera- 
peutic merits  of  this  and  of  that  could 
readily  assent  to  the  same  glorious  con- 
clusion. 

Strange  to  say,  there  are  in  New  York 
physicians  who  are  in  the  habit  of  insert- 
ing a  rubber  bougie  up  their  patients' 
rectums  two  or  three  times  a  week  for 
the  cure  of  constipation.  Some,  more 
bold,  intrust  the  bougie  performance  to 
the  patient  in  order  that  a  daily  dilatation 
and  stimulation  may  be  kept  up  until 
"recovery  from  the  disease  is  effected." 
Others,  more  original,  order  the  patient 
to  insert  a  candle  some  six  inches  in 
length  up  the  rectum  and  allow  it  to 
remain  ten  minutes,  with  the  hope  of  a 
"rapid  cure," 

7$ 


Theories  and  Medication 

A  Mrs.  P ,who  had  used  the  candle 

treatment  for  a  great  length  of  time  by 
order  of  her  distinguished  physician,  once 
consulted  me.  On  examination,  I  found 
her  afflicted  with  atrophic  catarrh,  chronic 
constipation  and  anal  ulceration,  from 
which  she  had  suffered  for  seven  years, 
with  but  little  intermission  from  pain 
during  each  day  of  that  entire  period. 


77 


c 


CHAPTER  X. 

BILIOUSNESS    AND   BILIOUS  ATTACKS. 

OMMONLY  the  source  of  chronic 
gastro-intestinal  uncleanliness,  of 
dyspepsia,  of  autogenetic  poisons  and 
auto-infection  is  inflammatory  occlusion 
— more  or  less  permanent  or  spasmodic — 
of  some  part  of  the  lower  bowel.  Many 
years  of  auto-infection  will  exhibit  such 
diseased  symptoms  as  poor  appetite,  bad 
digestion,  impoverished  blood,  emaciation, 
etc.,  accompanied  by  increased  virulence 
of  the  catarrhal  discharge  of  mucus, 
shreds,  etc.,  and  a  mind  and  body  sinking 
down  to  the  morbid  plane  of  hysteria, 
hypochondriasis  (fear  of  illness)  and  neu- 
rasthenia (debility  of  the  nervous  system). 
Biliousness  and  bilious  attacks  are  evi- 
dence that  there  is  a  more  or  less  consti- 
pated condition,  that  there  has  been  an 
occasional  imprudence  in    diet,  and    that 

78 


Intestinal  Foulness 

the  dreadful  sense  of  fulness  up  to  the 
end  of  the  tongue  is  a  faithful  report  of 
the  state  of  affairs.  What  is  it  but  a  full 
foul  condition  of  the  digestive  canal,  a 
complete  blockade  of  the  canal  from  the 
rectum  or  colon  to  the  stomach,  making 
the  victim  feel  that  there  must  be  some- 
thing done  in  the  way  of  cleaning  out  ? 
He  fears  that  the  condition  will  be  fol- 
lowed by  fever — not  infrequently  this  is 
the  case.  Biliousness  is  usually  supposed 
to  be  occasioned  by  hindrance  to  the  flow 
of  bile,  and  the  conclusion  is  drawn  that 
the  liver  requires  stimulating.  This  sup- 
position is  erroneous  and  very  far  from 
pathological  veritude,  as  the  liver,  like  the 
other  organs,  is  merely  a  secondary  stif- 
ferer  from  the  over-eating  and  the  closed 
sewer. 

"  The  bowels  with  sullen  vapours  cloud  the  brain, 
And  bind  the  spirits  in  their  heavy  chain  ; 
Howe'er  the  cause  fantastick  may  appear, 
The  effect  is  real,  and  the  pain  severe." 

The  bilious  attack  is  usually  noticed  in 
the  morning  before  food  has  been  taken. 

79 


Intestinal  Ills 

The  tongue  is  heavily  coated  and  often  so 
foul  that  it  is  necessary  to  scrape  it  and 
cleanse  the  mouth  of  disagreeable  taste. 
Eructations,  nausea  followed  by  vomiting 
of  undigested  foul-smelling  food,  and  if 
the  vomiting  be  long-continued,  mucus 
from  the  stomach  and  bile  that  had  ac- 
cumulated in  the  duodenum,  are  sufficient 
evidence  that  there  was  no  torpidity  of 
the  liver.  There  is  likewise  more  or  less 
headache,  neuralgia,  giddiness,  hebetude 
(state  of  mild  stupidity),  dejection,  con- 
fusion of  the  senses,  skin  disease,  acne 
rosacea  (scarlet  redness  of  the  nose  and 
cheeks),  eczema,  etc.  The  headache  may 
be  seated  in  the  centre  of  the  brain  and 
extend  to  one  or  both  eyeballs  and  be 
increased  by  stooping.  Should  diarrhea 
occur  many  of  the  annoying  symptoms 
are  likely  not  to  be  present. 

In  this  form  of  indigestion  the  bowels 
are  often  much  constipated,  which  is  usu- 
ally only  a  more  marked  symptom  of 
chronic    constipation.     The    system    now 

and  then  vigorously  rebels   against   this 

80 


Intestinal  Foulness 

chronic  condition  and  an  acute  bilious 
attack  is  the  evidence  of  such  rebellion. 
The  whole  digestive  canal  is  involved  in 
the  rebellion,  resulting  in  the  symptoms 
described  and  also  in  a  morose,  petulant 
and  querulous  temper,  accompanied  by  a 
peculiar,  despairing  expression,  —  partly 
due,  perhaps,  to  regrets  of  having  only 
one  digestive  apparatus, — or  in  some  cases, 
perhaps,  of  having  any. 

That  the  character  and  disposition  may 
be  materially  influenced  by  such  a  state 
of  the  bowels  is  well  established.  Plato 
believed  that  "  an  infirm  constitution  is  an 
obstacle  to  virtue,  because  such  persons 
think  of  nothing  but  their  own  wretched 
carcasses "  ;  for  which  reason  he  con- 
tended that  ^Esculapius  should  not  under- 
take to  patch  up  persons  habitually 
complaining,  lest  they  beget  children  as 
useless  as  themselves,  being  persuaded 
that  it  was  an  injury  both  to  the  commu- 
nity and  to  the  infirm  person  himself  that 
he  continue  in  the  world,  even  though  he 

were  richer  than  Midas. 
81—6 


Intestinal  Ills 

Acting  on  this  well-known  fact,  the  cele- 
brated Voltaire,  in  one  of  the  articles  in 
his  Philosophical  Dictionary,  has  very  hu- 
morously ascribed  half  the  evils  of  Europe 
to  the  intestinal  irritations  of  the  public 
men  of  the  age. 

"  Let  the  person,"  he  adds,  "  who  may 
wish  to  ask  a  favor  of  a  minister,  or  a 
minister's  secretary,  or  kept  mistress,  en- 
deavor previously,  by  all  means,  to  ascer- 
tain whether  they  go  to  stool  regularly  ; 
and,  if  possible,  to  approach  them  after  a 
comfortable  evacuation,  that  being  a  most 
propitious  moment,  one  of  the  mollia  tem- 
pora  fandi,  when  the  individual  is  good- 
humored  and  pleased  with  all  around 
him." 


82 


CHAPTER    XI. 

KING  LIVER  AND   BILE-BOUNCERS. 

THE"  house  not  made  with  hands  " — 
the  human  body  —  has,  like  the 
house  made  with  hands,  its  sewer  system, 
which  is  over  twenty-five  feet  in  length. 
To  cleanse  (?)  this  wonderfully  delicate, 
tortuous  and  extended  passage-way  of 
waste  material,  civilized  man  knows  no 
better  than  to  put  in  at  the  top  of  the 
house,  purgatives,  cathartics,  bile-boun- 
cers, etc.,  with  one  hope  and  purpose  in 
view,  namely,  that  these  policemen  go 
searching,  scouring  and  hustling  the  in- 
testines in  the  greatest  possible  haste,  in 
order  to  remove  an  obstruction  about 
three  hundred  inches  distant  from  where 
these  "forcers"  had  entered  the  intestinal 
sewer.  With  mercury  as  a  scavenger  the 
work  is  pretty  thoroughly  done,  though 
extra  care  has  to  be  taken  that  some  of 
83 


Intestinal  Ills 

the  teeth  may  remain  after  the  victim  sur- 
vives the  additional  intestinal  inflamma- 
tion occasioned  by  its  drastic  measures. 

Traits  acquired  by  the  father  are  in- 
herited by  the  children  ;  present-day  doc- 
tors follow  early  practitioners  ;  they  still 
pour  in  many  and  various  decoctions  at 
the  top  of  the  obstructed  sewer  of  the 
human  house  to  dislodge  accumulated 
gases  and  feces  at  the  bottom.  The 
plumber  treats  the  sewer  of  the  house  of 
brick  and  stone  more  wisely. 

Our  fathers  partook  of  laxatives,  ca- 
thartics, purgatives,  and  in  consequence 
we  start  in  life  with  teeth,  intestines, 
appendices,  out  of  gear  and  nervous 
systems  on  edge.  With  unconscious  stu- 
pidity we  continue  the  fatuous  practice. 
The  monarch  selected  to  preside  over  the 
functions  of  human  life  was  the  Liver  ; 
and  it  is  only  with  bated  breath  that  any 
doctor  dares  question  the  legitimacy  of 
that  monarch's  claim.  The  loyal  subjects 
of  King  Liver  are  ever  ready  to  call  out 
"  quack,"  "  charlatan,"  etc.,  to  those  who 

84 


Hereditary  Medication 

dare   repudiate    the    sovereignty    of    the 
Liver. 

So  much  attention  and  flirtation  does 
the  liver  receive  from  the  liver-persuaders 
that  the  pancreas  ought  to  be  very  jealous. 
The  pancreas  excretes  quite  as  much  fluid 
into  the  duodenum  as  its  larger  neighbor, 
and  is,  therefore,  no  mean  organ.  And 
we  need  not  wonder  should  we  find  the 
intestinal  glands  piqued  at  our  over-atten- 
tion to  the  liver,  as  they,  in  their  work  at 
the  metamorphosis  of  digested  food  into 
blood,  excrete  two  or  three  gallons  of  fluid 
in  a  day  to  the  liver's  two  or  three  pints  ; 
yet  witness  our  medieval  solicitude  for  the 
liver,  for  one  among  many  organs.  The 
liver  is  located  near  the  upper  portion  of 
the  intestinal  canal  and  connected  by  a 
tube  (the  bile  duct)  to  the  rest  of  the  ex- 
cursion route.  The  following  liver-per- 
suading knights-errant  are  prescribed  and 
ordered  by  disciples  of  Hippocrates, 
Galen,  Herodicus,  and  Iccus,  to  treat 
with  that  digestive  and  eliminative  mon- 
arch,  the  Liver  —  usually  at  night-time, 
85 


Intestinal  Ills 

that  the  family  may  not  be  disturbed. 
After  making  as  good  terms  as  possible 
they  journey  on,  riotously  churning  and 
swashing  the  lono-  tortuous  canal  and  its 
contents  in  search  of  ancient  toxic  erases 
and  feces  lodged  in  the  lower  bowel.  It 
is  believed  by  the  prescribers  that  the 
length  of  the  journey  adds  dignity  to  the 
drastic,  dredofincf  knights-errant.  The 
reader  needs  no  introduction  to  the  po- 
dophyllins,  the  aloes,  the  jalaps,  the  rhu- 
barbs, the  mercurys,  the  croton  oils,  the 
sennas,  the  salines,  the  seltzers,  the  Car- 
ters, the  Beechams,  the  Websters,  the 
Pierces,  the  Ayers,  the  Ripans,  the  War- 
ners, and  others  belonging  to  "  The  Four 
Hundred"  fashionable  grenadiers,  with 
their  credentials  and  stamp  ! 

After  these  knights-errant  have  paid 
their  respects  to  King  Liver,  and  ended 
their  long,  tortuous  and  eventful  journey, 
they  depart  and  leave  behind  them  burn- 
ing and  painful  abdominal  and  anal  re- 
grets, and  then  some  soothing,  stimulating 
and  tonic  remedies  are  in  order,  so  that 

86 


Hereditary  Medication 

the  dredged  though  chronically  consti- 
pated sufferer  and  his  friends  may  still 
hope  that  life  will  be  spared  to  repeat  the 
same  nauseating  and  often  painful  process 
in  a  few  days  or  weeks,  taking,  in  the 
meanwhile,  milder  bile-bouncers  daily  as  a 
reminder  to  Kingf  Liver  that  the  time  for 
the  knights-errant  is  coming  again. 

Sufferers  from  chronic  constipation  re- 
ceive assurances  that  by  the  use  of  these 
"  remedies  "  the  anemia  will  be  corrected, 
nutrition  and  digestion  restored,  atony  of 
the  liver  and  intestines  overcome,  yellow 
complexion  and  morbid  feeling  disappear. 
In  short,  remove  the  numerous  symptoms 
and  "  causes  "  of  toxicity  of  the  body  and 
of  chronic  constipation,  and  proclaim  the 
victory  of  Powder  and  Pill  ! 

All  of  us  would  believe  Medicus,  the 
son  who  so  abjectly  follows  in  the  foot- 
steps of  his  father,  if  we  could  really  feel 
the  possibility  of  such  a  victory  ;  but  the 
protests  of  our  bowels  are  living  witnesses 
against  the  validity  of  the  medieval  prac- 
tice as  here  described  ;  and  we  ask  for  a 

87 


Intestinal  Ills 

modern  scientific  solution  of  the  fulness 
and  foulness  within  and  the  fatuity  with- 
out. 

I  must  now  apologize  to  the  large  class 
of  sufferers  from  chronic  constipation  for 
hurting  their  feelings.  I  know  very  well 
how  seriously  they  have  been  compelled  to 
regard  their  trouble,  and  out  of  respect  for 
their  protracted  suffering  and  efforts  to  get 
relief  I  should  instead  have  sympathized 
and  condoled  with  them  in  their  dire  mis- 
fortune. But  we  all  know  and  realize 
that  there  are  occasions  when  we  get  into 
awful  and  painful  predicaments,  and,  when 
the  whole  situation  is  taken  in,  it  becomes 
comical  and  ridiculous,  so  that  for  a  time 
we  cannot  treat  it  seriously,  even  when 
old  Chronic  Biliousness  and  the  mighty 
knights-errant  are  having  a  deadly  com- 
bat at  our  internal  and  external  (and  pos- 
sibly infernal)  expense. 


88 


CHAPTER  XII. 

SEMI-CONSTIPATION  AND   ITS   DANGERS. 

"  At  least  six  times  in  every  fleeting  day- 
Some  tribute  to  the  renal  functions  pay, 
And  twice  or  thrice  all  alvine  calls  obey." 

WHAT  has  been  said  thus  far  has 
been  based  on  chronic  constipa- 
tion mainly,  and  the  accompanying  intes- 
tinal foulness,  which  condition  was  shown 
to  be  so  annoying  that  it  compelled  the 
sufferer  to  resort  frequently  to  some  more 
or  less  direct  and  artificial  means  for  the 
relief  of  the  bowels  and  the  incidental  in- 
digestion. It  has  been  further  shown  that 
many  of  the  chronic  cases  fail  to  take  on 
the  normal  amount  of  flesh  or  lose  what 
flesh  they  have  because  of  self-poisoning 
(auto-infection),  which  in  turn  is  the  out- 
come of  mal-assimilation  and  mal-nutri- 
tion,  and  that  this  consequence  must 
occur  wherever  there  is  an  absorption  of 
89 


Intestinal  Ills 

waste  through  a  checking  or  disturbance 
of  systemic  functions.  Emaciation  and 
anemia  are  inevitable  in  such  cases.  On 
the  other  hand,  there  are  cases  that  have 
such  great  powers  of  assimilation  and 
elimination  that  they  are  able  to  stand 
the  invasion  of  destructive  material,  may 
maintain  the  normal  amount  of  flesh,  or 
even  take  on  an  abnormal  amount,  but 
with  the  invariable  accompaniment  of 
more  or  less  impoverishment  of  blood, 
disturbed  circulation,  indigestion,  and  the 
usual  nervous  derangements.  The  harm- 
ful practice  of  the  lean  and  the  fleshy 
sufferers  of  resorting  to  daily  medicines — 
cathartics,  digestives  and  tonics  —  has 
been  commented  upon.  Willingly  do 
they  squander  their  money  to  get  relief 
from  an  ever-present  ailment.  Cases  are 
these  of  hope  deferred  that  maketh  the 
heart  sick. 

The  primary  cause  of  chronic  consti- 
pation, namely,  proctitis,  has  been  ex- 
plained, and  its  many  symptoms,  as  in- 
dicated by  the  functional  disturbances  of 

90 


Semi-Constipation 

many  or  all  of  the  organs  of  the  body, 
enumerated. 

But  beside  the  cases  of  chronic  consti- 
pation —  both  lean  and  fat  —  there  are 
many  sufferers  from  auto-infection  who 
have  only  semi-constipation,  or  partial 
evacuation  of  the  feces  daily.  Though 
they  suffer  from  the  effects  of  self-poison- 
ing, yet  they  have  no  such  well-defined 
symptoms  of  local  disease  and  functional 
disturbance  as  are  always  found  in  those 
who  have  chronic  constipation.  Never- 
theless, they  have  disturbances  of  prac- 
tically all  the  functions  of  the  system. 
Believing  as  they  do  that  the  evacuation 
of  their  bowels  is  complete,  they  are  at  a 
loss  to  find  a  cause  for  the  toxemia 
(blood-poisoning),  mal-nutrition,  debility 
and  general  atony.  The  symptoms  of 
auto-infection  with  the  semi-constipated 
are  as  complex  as  with  the  severer  cases, 
but  not  so  well  defined.  The  most  promi- 
nent symptoms  are  those  connected  with 
the  process  of  katabolism,  that  is,  of  degen- 
eration of  the  tissues,  as  indicated  by  their 

91 


Intestinal  Ills 

color  and  texture.  The  liver,  however, 
is  usually  held  responsible  for  the  bad 
complexion,  impaired  nutrition,  constipa- 
tion and  diminished  vitality,  when  really 
the  liver  is  only  indirectly  concerned,  as 
made  manifest  in  the  previous  articles. 
The  seat  and  source  are  found  to  be  the 
diseased  colon  and  rectum. 

Dr.  Treves  says :  "  The  colon  being 
the  part  of  the  bowel  involved  in  obstruc- 
tion due  to  fecal  accumulation,  it  may  be 
further  assumed  that  the  blocking  of  the 
gut  will  most  usually  concern  its  lower  or 
terminal  parts.  Accumulation  of  feces  is 
most  common  in  the  rectum  and  sigmoid 
flexure,  and  then  in  the  cecum.  Masses 
of  feces  may  block  the  colon  at  any  point, 
and  more  particularly  at  the  flexures  of 
the  bowel.  Still,  the  three  common  sites 
of  the  accumulation  are  those  just  named. 
The  accumulation  in  the  colon  may  as- 
sume the  form  of  a  more  or  less  isolated 
nodule  or  mass.  Thus  a  considerable 
lump  may  be  found  in  the  cecum  or  sig- 
moid flexure  and  the  rest  of  the  colon  be 
comparatively  clear  of  any  gross  accumula- 
tion.    An  isolated  lump  may  even  persist 

92 


Semi-Constipation 

after  free  purgation.  On  the  other  hand, 
the  accumulation  may  assume  the  form 
of  several  isolated  fecal  masses.  One  of 
them  may  occupy  the  cecum,  another  the 
transverse  colon,  and  possibly  a  third 
the  sigmoid  flexure.  The  bowel  between 
these  masses  may  appear  to  be  fairly 
clear." 

A  number  of  the  exciting  causes  of 
inflammation  of  the  lower  or  terminal 
portion  of  the  large  intestine  have  been 
mentioned.  It  cannot,  however,  be  too 
strongly  emphasized  that  chronic  inflam- 
mation of  the  colon  and  rectum  results 
in  hyperkinesis  (excessive  muscular  irrit- 
ability) and  contraction  of  the  diseased 
portion  invaded,  thereby  retarding  or 
preventing  the  passage  of  feces  and  gases. 
A  portion  of  the  daily  accumulation  of 
feces  in  the  sigmoid  may  pass  through 
the  diseased  rectum  every  day,  but  not 
without  increasing  the  inflammation  and 
the  spasmodic  contraction  ;  this  in  time 
inhibits  the  elimination  of  the  accumulat- 
ing feces,  which  by  undue  retention  be- 

93 


Intestinal  Ills 

come  condensed  and  hardened.  Each 
day  will  then  be  a  repetition  of  the  ab- 
normal and  partial  effort  of  the  organ 
to  accomplish  the  act  of  defecation,  and 
there  will  be  no  thought  of  the  cumulative 
and  chronic  intoxication  (poisoning)  of 
the  system  from  the  imprisoned  feces  and 
gases. 

It  may  be  stated  without  reservation 
that  the  rectal  canal  cannot  be  involved 
in  chronic  inflammation  without  involving 
the  anal  canal,  and  vice  versa.  One  half 
of  civilized  people  are  suffering  from 
chronic  constipation,  and  very  nearly  the 
remainder  from  semi-constipation.  The 
semi-constipated  are  now  under  considera- 
tion. The  chronic  cases  are  those  that 
have  a  complete  impaction  of  feces  in 
the  terminal  portion  of  the  sigmoid  and 
rectum  ;  the  semi-constipated  have  the 
usual  daily  partial  impaction,  that  is,  an 
incomplete  or  partially  successful  evacu- 
ation of  the  contents  of  the  bowels  :  the 
incompleteness  is  due  to  disease  of  the 
anal  and  rectal  canals. 

94 


Semi-Constipation 

The  anal  and  rectal  canals  are  made 
up  of  circular  and  longitudinal  muscular 
bands,  which,  when  invaded  by  disease, 
lose  their  proper  or  normal  sensibility 
and  cooperative  voluntary  action.  The 
excessive  contraction  of  the  circular  mus- 
cles closes  the  calibre  or  bore  of  the 
gut,  and  the  excessive  contraction  of  the 
longitudinal  muscles  shortens  the  length 
of  the  gut,  thus  throwing  the  mucous 
membrane  into  abnormal  folds  which 
increase  the  depth  of  the  sacculi,  or  cavi- 
ties, between  the  fibrous  folds.  In  the 
normal  oait  the  sacculi  and  bands  act 
as  valves  to  control  the  descent  of  the 
feces.  This  valvular  arrangement  and 
the  curvatures  of  the  lower  bowels  con- 
serve the  energy  of  the  involuntary  and 
voluntary  nerve  force  until  there  is  a 
sufficient  accumulation  of  feces  to  excite 
a  normal  desire  for  stool  ;  otherwise  the 
feces  would  rush  upon  the  anus  at  once 
and  occasion  much  inconvenience. 

Catarrhal  inflammation  of  the  mucous 
membrane  of  the  anal  canal  will  sooner 

95 


Intestinal  Ills 

or  later  penetrate  the  muscular  structure 
of  that  canal,  causing  an  abnormal  irrita- 
bility and  contraction  of  the  sphincter 
ani  and  the  other  tissues  composing  its 
structure.  The  contraction  of  the  anal 
tissues  becomes  more  permanent  as  the 
muscular  tissues  of  the  structure  become 
cohered  or  bound  together  by  the  process 
of  inflammation. 

The  normal  stimulus  and  sensation  that 
should  precede  the  act  of  defecation  are 
perverted  or  destroyed  by  the  excessively 
irritable  contraction  of  the  sphincter  ani, 
which  contraction  is  occasioned  by  the 
presence  of  feces  and  gases  just  above 
the  seat  of  inflammation,  that  is,  above 
the  anal  canal  or  at  the  lower  end  of  the 
rectum.  As  the  bulk  of  feces  and  gases 
lodged  at  this  point  increases,  the  anal 
contraction  becomes  firmer  in  grip,  and 
as  a  consequence  permits  no  hint  of  the 
imprisoned  contents  until  the  accumulat- 
ing bulk  is  beyond  the  power  of  tolera- 
tion by  the   organ.       Daily  a  portion  of 

the  lodged  feces,  or  some  new  addition 

96 


Semi-Constipation 

to  the  mass,  passes  the  anal  canal,  but 
the  attending  irritation  or  contraction  of 
the  muscles  prevents  any  further  exit 
of  the  imprisoned  rectal  contents. 


97—? 


CHAPTER  XIII. 

THE  ETIOLOGY  OF  THE  MOST  COMMON  FORM 
OF  DIARRHEA,  I.  E.,  EXCESSIVE  INTES- 
TINAL PERISTALSIS. 

IF  you  are  interested  to  know  why  a 
certain  plant  does  not  flourish  in  the 
temperature  and  light  to  which  it  has  been 
accustomed,  you  investigate  the  soil — the 
source  of  nourishment  —  and  thus  deter- 
mine why  the  downy  or  velvety  appear- 
ance has  left  the  flower  ;  why  the  leaves 
are  yellow,  dry  or  falling  ;  why  the  stems 
are  withering-.  Even  the  most  ignorant 
person  knows  that  the  symptoms  the  plant 
presents  did  not  bring  about  the  unsuita- 
bleness  of  the  soil  ;  that,  on  the  contrary, 
the  condition  of  the  soil  is  responsible  for 
the  plant's  present  state.  Would  it  not 
be  unwisdom,  therefore,  to  treat  directly 
the  symptoms  of  decay,  instead  of  treat- 
ing  the    soil,    or    changing   it?     Just    so 


Intestinal  Absorption 

misguided  is  the  judgment  of  the  physician 
who  prescribes  physic  or  tonics  in  the  case 
of  a  person  having  a  foul  intestinal  canal, 
a  condition  destructive  of  the  absorbent 
and  the  excretory  glands.  But  members 
of  county  medical  societies  do  just  such 
foolish  things.  Notwithstanding  their 
prescriptions,  a  point  will  be  reached  by 
the  patient  where  the  restoration  of  his 
millions  of  small  rootlets,  or  organic  feed- 
ers, will  be  impossible,  and  like  a  decaying 
plant  in  unfavorable  soil  he  gradually  de- 
cays or  withers,  here  and  there,  until 
finally  he  topples  over  before  he  knows  it, 
probably  long  before  maturity  has  been 
reached. 

It  is  not  generally  known  among  lay- 
men, nor  sufficiently  appreciated  among 
physicians,  that  the  mass  of  fecal  matter 
normally  evacuated  from  the  bowels  comes 
mainly  from  the  blood  ;  and  that  this  mass 
is  not,  as  it  is  usually  supposed  to  be,  the 
residue  of  the  food  that  has  been  left  un- 
assimilated.  Embedded  in  the  mucous 
membrane  of  the  colon  are  tubular  glands 

99 


Intestinal  Ills 

under  the  control  of  the  nervous  system. 
When  these  glands  become  unduly  ex- 
cited through  local  inflammation  and  irri- 
tation, the  normal  ilow  from  them  is 
increased  to  such  an  extent  that  a  rapid 
waste  of  precious  tissue  occurs  throughout 
the  system,  and  the  vital  force — which  had 
taken  perhaps  years  to  store — is  depleted 
to  the  point  of  exhaustion,  sometimes  even 
in  a  few  hours.  Almost  every  one  has 
had  some  experience  of  exhaustion  fol- 
lowing diarrhea. 

The  increased  flow  of  blood  to  the 
mucous  membrane  of  the  colon  furth- 
ers this  extraordinary  secretion  by  the 
glands.  As  has  been  pointed  out,  inflam- 
mation, septic  poisoning,  intestinal  foul- 
ness, or  retained  feces,  act  as  irritants  on 
the  mucous  membranes,  thereby  drawing 
the  blood  to  the  colon  where  it  is  excreted 
and  exhaustion  follows.  The  great  dan- 
ger in  diarrhea,  therefore,  is  the  rapid 
depletion  of  the  vital  force.  But  when 
the  small  intestines  are  affected  the  con- 
sequences may  be  still  more  deplorable. 


Intestinal  Absorption 

Then  the  unassimilated  food  is  hurried 
along  too  quickly  for  absorption  and  the 
body  receives  but  little  nourishment  to  re- 
store its  powers.  Thus  another  draught 
is  made  upon  the  sufferer's  reservoir  of 
vitality,  and  hence  additional  exhaustion. 
But  this  waste  of  tissue,  loss  of  vital  force, 
non-assimilation  and  non-supply,  are  not 
so  grave  as  the  positive  danger  of  the 
permanent  destruction  of  the  millions 
of  small  absorbing  vessels  (villi)  of  the 
small  intestine  by  a  continuance  of  this 
abnormal  irritation.  Of  course  the  secre- 
tory and  excretory  glands  of  the  colon 
also  suffer,  and  we  then  have  costive- 
ness  resulting  from  lack  of  absorption 
and  excretion. 

Abnormal  irritability  of  the  bowels  is 
necessarily  involved  in  the  inflammatory 
process  known  as  proctitis  and  colitis. 
Increase  this  irritability  to  a  certain  point 
and  diarrhea  takes  the  place  of  constipa- 
tion—  a  much  more  alarming  symptom. 
Diarrhea  is  more  alarming  because  the 
intensified  local  activity  of  the   excretory 

101 


Intestinal  Ills 

glands  of  the  bowels  brings  on,  as  has 
been  said,  a  general  exhaustion  of  the 
vital  powers. 

The  severity  of  diarrheal  symptoms  is 
much  increased  by  the  character  and  abun- 
dance of  bacterial  poisons.  Bacteria  find 
a  ready  medium  in  fetid  feces,  and  are 
absorbed  by  the  excited  glands  to  the 
degree  in  which  these  o-lands  have  time 
and  power  for  absorption.  Of  course  the 
extent  and  character  of  the  intestinal  irri- 
tation have  a  good  deal  to  do  with  the 
severity  of  the  diarrheal  symptoms.  This 
irritation  is  not  infrequently  intensified  by 
a  catarrhal  process,  or  by  a  lesion  of  an 
ulcerative  nature.  All  these  forms  of 
irritation  brino-  on  "  excessive  intestinal 
peristalsis"  —  which,  accordingly,  is  our 
definition  of  diarrhea.  The  normal  peri- 
staltic action  of  the  intestines  propels  the 
nutritive  as  well  as  the  effete  material 
through  the  canal  at  a  rate  that  allows  of 
both  proper  absorption  and  timely  elimi- 
nation. But  when  excessive  peristalsis 
occurs,  neither  absorption  nor  elimination 


Intestinal  Absorption 

will  be  normal  or  suited  to  the  require- 
ments of  the  system. 

Undigested  foodstuffs  may  become  an 
irritant,  or  increase,  as  is  usually  the  case, 
the  established  irritation,  and  thus  bring 
on  an  acute  attack  of  diarrhea.  The  im- 
mediate consequence  of  the  acute  attack 
may  indeed  be,  and  often  is,  comparatively 
beneficial,  inasmuch  as  the  diarrhea  re- 
moves the  undigested  material  that  occa- 
sioned the  irritation.  When  this  removal 
is  accomplished,  the  diarrhea  usually  sub- 
sides without  treatment.  This  is  the  case, 
however,  only  when  the  patient  has  com- 
mitted an  infrequent  error  in  diet.  When 
such  errors  are  habitual  the  burden  on  the 
glands  of  the  intestinal  mucous  membrane 
becomes  intolerable,  and  the  chronic  in- 
flammation once  established  has  a  ten- 
dency to  proceed  from  bad  to  worse.  It 
will  then  be  observed  that  digestion  be- 
comes more  and  more  impaired.  In  such 
a  case  diarrhea  will  no  longer  serve  a  good 
end,  but  will   on  the  contrary  debilitate 

the  system.     A  change  to  better  dietetic 
103 


Intestinal  Ills 

habits  will  then  aid,  but  will  not  suf- 
fice for  cure.  Only  treatment  and  time 
will  restore  the  inflamed  parts  to  a  healthy 
tone.  When,  however,  the  digestive  tract 
is  invaded  by  any  of  the  many  forms  of 
bacteria,  treatment  will  avail  little  and 
serious  consequences  follow  rapidly. 

Too  much  cannot  be  said  or  done  to 
secure  intestinal  cleanliness  in  infancy, 
childhood  and  maturity.  Mothers  and 
nurses  cannot  give  this  subject  too  much 
thought  and  care,  since  the  welfare  of 
future  generations  depends  largely  upon 
intestinal  cleanliness,  in  view  of  the  rich 
and  racy  life  of  our  hothouse  civilization. 
We  are  a  people  poisoned  through  consti- 
pation and  diarrhea  :  two  affections  that 
derange  more  lives  than  all  other  patho- 
logical conditions  together.  Banish  ali- 
mentary uncleanliness  and  you  take  most 
of  the  poisons  from  the  human  race — 
poisons  that  stunt  the  body  and  blunt 
the  mind. 

The   soul    of   man    should   dwell  in   a 

palace,  not  in  a  pest-house ;  in  a  human 

104 


Intestinal  Absorption 

temple,  velvety,  lined  with  down,  inside 
and  out ;  in  which  there  are  hundreds  of 
millions  of  lilliputian  trappings,  fittings 
and  articles  of  furniture,  to  carry  on  the 
minute  and  finer  functions  and  chemistry 
of  the  soul.  The  very  multitude  of  the 
fine  equipments  that  decorate  the  tem- 
ple give  it  that  beautiful  blending  of  color 
and  form  which  its  coating  has  when  in 
normal  condition.  They  adorn  this  body- 
house  with  health,  and  supply  it  with  the 
rich  red  wine  of  joy. 

The  blood  is  dependent  for  its  richness 
not  only  on  the  digestive  fluids,  but  also 
on  the  proper  eliminating  powers  of  the 
system.  If  you  would  avoid  premature 
decay  you  must  not  neglect  the  reservoir 
of  vitality,  the  alimentary  canal,  but  see 
to  it  that  it  be  kept  clean  and  pure.  Then 
will  the  elixir  of  life  spring  from  an  almost 
inexhaustible  fountain.  To  recur  to  our 
plant  analogy.  Keep  the  soil  in  your 
own  vegetable  garden  sweet,  for  intestinal 
cleanliness  corresponds  to  soil  fitness. 
Purity  of  the  stomach  and  bowels  is  more 
105 


Intestinal  Ills 

important  than  quantity  or  quality  of  food. 
That  defecation  should  occur  normally 
two  or  three  times  in  twenty-four  hours  is 
more  important  than  that  three  meals 
should  be  eaten  within  that  time.  The 
conveniences  for  eating  and  drinking-  are 
on  every  hand,  but  oh,  how  few,  inacces- 
sible, miserably  constructed,  and  poorly 
cared  for,  are  the  toilet  cabinets  for  the 
accommodation  of  the  gourmand  !  Sus- 
penders and  silk  hats  mark  the  progress 
cf  our  outer  refinement ;  toilet  cabinets 
and  flushing  appliances,  of  our  inner. 
When  the  inner  refinement  comes  we 
shall  live  longer  and  be  healthier. 


106 


CHAPTER   XIV. 

BALLOONING   OF   THE   RECTUM. 

TO  make  plainer  what  has  been  said  of 
the  rectal  and  anal  tubes  or  canals, 
consider  the  sleeve  of  an  infant's  crown. 
This  sleeve  well  represents  the  rectal  tube, 
the  wrist-band  the  anal  orifice  and  tube — 
an  inch  or  more  long.  Think  of  the  sleeve 
or  rectal  tube  as  being  made  up  of  four 
layers  of  material  or  membranes ;  and 
counting  from  the  inside  of  the  sleeve  or 
rectum  there  are  (i)  the  mucous  layer  ; 
(2)  the  areolar  layer  ;  (3)  the  muscular 
layer  ;    (4)   the  serous  layer. 

The  muscular  membrane  is  itself  com- 
posed of  two  layers,  and  may  be  said  to 
form  the  framework  of  the  rectum.  One 
layer  is  composed  of  circular  muscular 
fibres,  and  the  other  of  longitudinal  muscu- 
lar fibres.      In  a  similar  manner  you  could 

make  a  sleeve  out  of  fine  circular  rubber 
107 


Intestinal  Ills 

bands  ;  then  bind  them  together  by  rub- 
ber strings  extending  lengthwise  of  the 
sleeve.  With  the  circular  bands  the  bore 
of  the  sleeve  may  be  contracted  or  wid- 
ened ;  and  with  the  longitudinal  bands 
the  length  may  be  shortened  or  extended. 
Just  so  with  the  corresponding  muscular 
membranes  of  the  rectum,  in  their  normal 
and  abnormal  conditions.  Outside  of  the 
longitudinal  muscular  bands  are  the  se- 
rous  and  areolar  layers,  the  latter  covering 
the  lower  half  of  the  rectum. 

As  you  look  inside  the  incomplete 
model  of  the  rectum,  or  rather  sleeve, 
you  observe  circular  muscular  bands  or 
fibres  which  it  is  necessary  to  cover  with 
soft  spongy  or  fatty  substance  in  whose 
meshes  are  nerves,  blood-vessels,  etc. 
This  is  called  the  areolar  layer  or  coat. 
One  more  layer  or  coat  upon  this  —  the 
mucous  coat  —  completes  the  structure. 
This  latter  possesses  the  power  of  ac- 
commodating itself  to  the  distention  and 
contraction  of  the  muscular  tube.      The 

mucous  membrane    is  thrown   into  folds 

108 


Structure  of  Rectum 

and  columns  which  serve  as  valves  to  in- 
hibit the  undue  descent  of  the  feces,  thus 
assisting  the  mucous  membrane  in  per- 
forming-- its  office. 

The  length  of  the  rectum  varies  in  dif- 
ferent  persons,  six  inches  is  the  average 
length.  It  is  divided  into  two  parts.  The 
upper  part  is  a  little  more  than  three 
inches  long ;  beginning  in  front  of  the 
third  sacral  vertebra  and  extending  down 
to  the  end  or  tip  of  the  coccyx.  In  shape 
this  part  conforms  to  the  curve  of  the 
sacrum  and  the  coccyx,  to  which  it  is  at- 
tached behind.  The  lower  part  of  the 
rectum  is  a  little  shorter  than  the  upper 
part,  and  begins  at  the  tip  of  the  coccyx 
and  extends  down  with  the  same  curve  as 
the  upper  part,  terminating  at  the  upper 
portion  of  the  anal  canal. 

Returning  to  the  sleeve  again  ;  the  por- 
tion of  it  from  the  shoulder  to  the  elbow 
illustrates  the  upper  part  of  the  rectum 
when  partially  covered  with  a  serous  coat 
on  the  side  opposite  the  bore  (the  out- 
side).     From  the  elbow  to  the  wrist-band 

109 


Intestinal  Ills 

illustrates  the  lower  part  of  the  rectum, 
when  covered  on  the  outside  with  an 
areolar  coat. 

The  wrist-band  of  the  sleeve  will  repre- 
sent the  anal  tube  if  drawn  into  a  pucker 
and  turned  slightly  backward  from  the 
direction  of  the  sleeve  of  which  it  is  a 
continuation. 

The  muscular  fibres  described  above 
likewise  enter  into  the  formation  of  the 
anal  canal  or  orifice.  This  orifice  is  closed 
by  two  strong  muscles  that  lie  close  to- 
gether and  are  called  internal  and  ex- 
ternal sphincters,  which  are  abundantly 
supplied  with  nerves  and  blood-vessels 
whose  branches  extend  to  the  neighboring 
organs. 

Nine  persons  in  every  ten  have  more 
or  less  chronic  inflammation  of  the  mucous 
membrane  of  the  anus  and  rectum.  In 
time  the  areolar  and  muscular  coats  be- 
come invaded  by  the  morbid  process,  and 
this  increases  the  irritability  of  the  tissues 
of  the  organ. 

The  change  from  the  normal  functions 


Structure  of  Rectum 

of  the  anal  membranes  is  slow,  and  the 
symptoms  are  not  well  marked  and  are 
consequently  ignored  for  years  owing  to 
inexpertness  in  detecting  an  invading  seri- 
ous disease,  until  the  time  comes  when 
the  suffering  can  no  longer  be  tolerated 
by  the  victim  of  the  neglect. 

The  result  of  disease  to  muscular  tissue 
is  contraction  of  its  fibres,  and  the  contrac- 
tions become  more  painful  as  the  disease 
increases.  Accompanying  the  inflamma- 
tion, there  is  a  more  or  less  inflammatory 
product  secreted  between  muscular  fibres 
that  "  glues  "  them  together  in  their  con- 
tracted state.  And  as  the  anal  and  rectal 
tubes  are  made  up  of  round  muscular  fi- 
bres, it  is  not  hard  to  see  how  the  bore 
of  the  canal  can  be  lessened  by  the  slow 
binding  together  of  its  fibres  in  the  con- 
tracted state.  The  fact  is  that  when  the 
anal  structure  is  invaded  by  inflammation, 
there  is  more  or  less  stricture  of  the  canal 
and  of  the  orifice. 

Recalling  the  sleeve  illustration,  and 
how   the   wrist-band   was    puckered   and 


Intestinal  Ills 

bent  back  a  trifle  so  that  the  contents  of 
the  sleeve  would  not  pass  out  so  easily, 
suppose  you  now  pucker  the  wrist-band 
rather  tightly,  and  suppose  there  is  a 
forcible  descent  of  sand  in  the  sleeve,  the 
natural  result  would  be  a  bulging  out  of 
the  lower  portion  of  the  sleeve  just  above 
the  wrist-band,  or  place  of  undue  constric- 
tion. If  the  abnormally  constricted  con- 
dition of  the  anal  orifice  has  been  growing 
from  bad  to  worse  for  years,  the  locality 
immediately  above  the  anal  canal  will 
become  dilated  or  cavernous  (caused  by 
retained  feces  or  gases),  which  cavity  is 
called  ballooning  of  the  rectum.  When 
a  speculum  is  introduced  into  the  rectum 
(as  shown  on  page  14  of  pamphlet  Hozv 
to  Become  Strong),  and  through  it  a 
bent  probe  is  inserted  to  determine  the 
depth  of  the  dilatation  or  abnormal  cavity, 
it  is  as  if  one  were  poking  inside  of  an 
inflated  balloon  :  hence  the  name. 

Anatomists  describe  the  rectum  as  ter- 
minating in  a  forward  pouch,  which  is 
close  to  the  prostate   gland  in  the  male 


Structure  of  Rectum 

and  the  lower  part  of  the  vagina  in  the 
female.  In  some  cases  there  may  be  such 
a  slight  pouch,  due  to  the  anal  canal  not 
following  the  direction  of  the  rectum,  and 
slightly  turning  backward  ;  but  in  most 
cases  such  a  normal  pouch  is  not  percep- 
tible or  observed  through  the  speculum. 
The  small  pouch  sometimes  found  on  the 
anterior  wall  of  the  rectum  I  have  thought 
due  to  a  very  acute  inflammation  on  the 
verge  of  forming  abscess,  which  often 
occurs  in  the  triangular  space.  (See  4 
in  diagram  in  pamphlet  cited  above.) 

Immediately  above  the  sphincter  mus- 
cles on  the  posterior  wall  of  the  rectum 
the  greatest  dilatation  is  found  (as  shown 
by  the  bent  probe),  and  extends  on  each 
side  with  less  depth  about  the  anterior 
wall  of  the  rectum. 

The  greater  portion  of  the  lower  part 
of  the  rectum,  which  part  is  about  three 
inches  long,  is  usually  involved  in  the 
dilatation  or  ballooning.  Often  the  upper 
half  or  more  of  the  anal  canal  is  also 
dilated    with    the     rectum,     leaving    the 

113— 8 


Intestinal  Ills 

sphincter  muscles  quite  bare  of  fatty  tis- 
sue, with  anal  length  of  a  quarter  of  an 
inch  or  less. 

Your  attention  was  called  to  a  sleeve 
containing  sand,  and  the  bulging  or  dila- 
tation  above  the  puckered  wrist-band  that 
was  an  inch  or  more  broad.  Now  sup- 
pose there  were  two  strong  rubber  rings 
at  the  lower  end  of  the  wrist-band,  whose 
power  of  resistance  to  pressure  is  much 
greater  than  the  tissues  above  them  form- 
ing the  wrist-band.  Naturally,  the  tissues 
which  form  the  upper  part  of  the  wrist- 
band would  dilate  the  same  as  the  termi- 
nal portion  of  the  sleeve  just  above  the 
wrist-band. 

Similar  changes  in  structure  or  forma- 
tion take  place  in  diseases  of  the  anal  and 
rectal  canals  which  result  in  ballooning 
of  the  rectum  ;  and  two  frail  constricted 
sphincter  muscles  are  left  to  guard  this 
balloon,  filled,  as  it  so  often  is,  with  feces 
and  gas. 

Chronic  inflammation,   that    results    in 

contraction  of  the  circular  muscular  fibres, 

114 


Structure  of  Rectum 

will  sooner  or  later  constrict  the  gut  so 
that  it  will  lose  its  normal  power  to  ex- 
pand without  causing  pain.  The  anal 
canal  may  be  said  to  be  strictured  to 
the  degree  in  which  it  is  unable  to  dilate 
normally,  and  this  strictured  condition 
usually  grows  from  bad  to  worse. 

The  first  symptom  of  rectal  disease  is 
usually  an  affection  of  the  anus,  which 
affection  occasions  an  inhibition,  that  is, 
a  reluctant  permission  for  the  passage  of 
the  feces  ;  and  this  inhibition  results,  con- 
sequently, in  some  degree  of  constipation. 
And  this  constipation  reacts  more  or  less 
on  the  peristaltic  action  of  the  bowels  and 
in  time  defeats  the  function  of  peristalsis. 
All  this  will  react  on  the  inflammatory 
processes  at  the  anus,  which  originally  en- 
gendered the  constipation.  The  narrow 
and  contracted  strait  or  canal  through 
which  the  feces  must  pass,  gives  a  tape- 
like shape  to  the  stools. 

The  anal  and  rectal  mucous  membrane 
is  of  a  firm  and  tough  structure,  similar 
to   the   integument   at  the   bottom   of   a 

"5 


Intestinal  Ills 

boy's  heel.  After  many  years'  observa- 
tion of  diseases  of  the  anus  and  rectum  I 
am  forced  to  conclude  that  as  a  rule  in- 
flammation exists  in  the  tissues  twenty  or 
more  years  before  the  severe  symptoms, 
such  as  piles,  fissure,  anal  pockets,  pruri- 
tus, hypertrophy,  atrophy,  tabs,  abscesses, 
and  fistula,  are  sufficiently  annoying  to 
compel  the  sufferer  to  seek  medical  aid.  I 
believe  it  to  be  of  as  much  importance  to 
give  early  attention  to  disease  of  the  anus 
and  rectum  as  to  teeth  and  eyes,  or  even 
more. 


116 


CHAPTER  XV. 

BALLOONING  OF  THE  RECTUM — CONTINUED. 

IN  the  last  chapter  a  description  was 
given  of  the  anatomy  of  the  anus  and 
rectum  ;  and  it  was  shown  how  a  chronic 
inflammatory  process  involving  these  or- 
gans develops  stricture  in  the  parts  in- 
vaded ;  and  it  was  shown  how  a  partial 
stricture  of  the  anal  canal  results  in  bal- 
looning or  dilatation  of  the  lower  part  of 
the  rectum.  The  primary  cause  of  all 
the  symptoms  of  rectal  disease  is  chronic 
inflammation  (proctitis)  involving  the 
whole  structure  of  the  anal  tubes  and  in 
a  few  cases  the  sigmoid  flexure  as  well. 

Perhaps  the  first  marked  symptom  of 
disease  of  the  rectum  is  constipation, 
semi-constipation  or  of  chronic  character. 
The  function  of  the  anus  and  rectum 
being  disturbed  by  the  inflammation,  the 
»7 


Intestinal  Ills 

fecal  mass  is  unduly  retained  and  its 
moisture  is  absorbed  by  the  system.  This 
accounts  for  the  condensed  and  hardened 
fecal  mass  in  isolated  lumps  of  various 
proportions.  A  hard-formed  stool  is  ab- 
normal, and  is  evidence  of  auto-infection. 
When  three-fourths  of  the  normal  fecal 
mass  has  been  re-absorbed  by  the  system, 
does  it  not  stand  to  reason  that  the  blood 
and  tissues  have  been  poisoned  by  their 
own  waste  products  (auto  -  intoxication) 
and  that  anemia,  emaciation  and  local 
disturbances  of  other  organs  of  the  body 
are  symptoms  of  such  intoxication  ? 

The  loading  and  blocking  of  the  sigf- 
moid  flexure  come  from  too  much  activity 
or  irritability,  dtie  to  inflammation,  of  the 
upper  half  of  the  rectal  tube.  A  conse- 
quence of  this  excessive  sensitiveness  is 
a  diminished  or  perverted  normal  stimu- 
lus, notice  or  desire,  that  the  act  of  defe- 
cation should  take  place. 

The  victim  of  proctitis  simply  forms  a 
habit  of  daily  soliciting  an  evacuation, 
though  the  normal  invitation  or  desire  to 

118 


Abnormal  Cavities 

stool  may  be  entirely  absent,  and  the 
evacuation  in  such  cases  is  attended  with 
more  or  less  delay  and  straining  effort 
to  accomplish  partially  or  wholly  the 
expulsion  of  the  more  or  less  inspissated 
feces. 

As  the  extreme  sensitiveness  of  the 
inflamed  upper  half  of  the  rectum  offers 
resistance  to  the  passage  of  the  fecal 
contents  of  the  sigmoid  flexure  ;  so,  in  a 
somewhat  similar  manner,  the  inflamed 
anal  tube,  in  its  more  or  less  constricted 
state,  prevents  the  passage  of  feces  and 
gases  as  they  approach  the  terminal  part 
of  the  rectum.  As  a  consequence,  the 
feces  and  gas  deposit  and  lodge  at  this 
latter  location,  producing  in  so  doing  the 
abnormal  cavity  called  ballooning  of  the 
rectum,  so  often  found  just  above  the  anal 
tube. 

The  greatest  depth  of  the  dilated  pouch 

is  on   the  posterior  wall   of  the   rectum, 

or  just  in  front  of  the  tip  of  the  coccyx. 

In    some  cases  the  pouch  measures  two 

and  a  half   inches  in  depth  at   the  back 
119 


Intestinal  Ills 

and  gradually  diminishes  in  depth  on  each 
side  as  you  near  the  anterior  wall  of  the 
rectum.  Often  the  upper  end  of  the 
anal  canal  is  higher  than  the  depressed 
circumference  of  the  spacious  cavity  that 
almost  surrounds  it.  The  irritable  orifice 
of  the  cavity  will  invariably  compel  a 
quantity  of  liquids  and  feces  to  lodge  in 
the  cavity  as  a  permanent  cesspool,  allow- 
ing the  absorbent  vessels  to  absorb  as 
much  as  they  can  by  incessant  work.  The 
height  or  length  of  this  abnormal  cone- 
shaped  rectal  cavity  is  from  two  to  three 
inches,  involving  usually  the  lower  half  of 
the  rectum.  The  anal  canal  frequently 
becomes  shortened  by  the  dilating  process 
to  a  quarter  of  an  inch,  leaving  two  frail, 
irritable  muscles  at  the  vent,  to  guard  the 
rectal  cavity.  And  fortunate  are  these 
two  thin,  sore,  contracted  muscles,  and 
the  possessor  of  them,  if  they  escape  the 
surgeon's  barbarous  notion  of  operating 
on  them. 

If  the  medical  butcher  has  operated  on 
them,  you  will  find  an  anal  canal  open  to 


Abnormal  Cavities 

such  an  extent  that  two  fingers  can  be 
inserted  without  distending  the  tissues  in 
the  least.  And  when  the  victim  of  bal- 
looning of  the  rectum  and  ignorant  op- 
eration makes  further  complaint  to  the 
surgeon  of  the  aches  and  pains,  he  is 
consoled  by  being  informed  that  the  end 
of  the  spine  will  have  to  be  removed. 
Irreparable  damage  done  and  no  aid  at 
all  received  !  It  is  a  pity  such  ignorance 
on  the  subject  should  exist  in  the  medical 
profession  in  this  city. 

The  abnormal  cavity,  so  difficult  to 
empty  properly  owing  to  its  depth  and 
diseased  outlet,  is  seldom  free  from  gases, 
feces  and  liquids.  Daily  evacuations  will 
not  empty  this  cavity,  nor  will  cathartics 
or  diarrhea.  A  permanent  cesspool  of 
poisons  is  this,  where  all  forms  of  poison- 
ous germs  are  propagated,  and  infect  the 
system  by  absorption.  No  use  to  take 
medicines  for  your  poor  blood,  bad  com- 
plexion and  horrid  feelings,  as  they  will 
not  cleanse  the  augean  stable  so  long 
neglected.     No   use  to  journey  to  other 


Intestinal  Ills 

localities  for  health  so  long  as  you  carry 
so  formidable  a  foe  to  health  with  you. 

The  mucous  membrane  in  the  chronic 
state  of  the  disease  presents  a  rather  dry, 
indolent  and  bluish  appearance,  except 
that  here  and  there  the  tissues  show  more 
activity  of  the  disease,  more  especially  so 
over  the  anal  region,  due  to  harsher  dis- 
turbance during  the  act  of  stooling.  In 
the  subacute  or  acute  stage  of  the  in- 
flammatory process  there  is  more  general 
redness  and  puffiness  of  the  mucous  mem- 
brane, or  a  swollen  condition  with  in- 
creased discharge  of  mucus  and  perhaps 
some  blood. 

There  is  a  heavy,  uncomfortable  feel- 
ing, with  more  or  less  soreness  and  pain, 
especially  after  evacuation  of  the  feces. 
If  a  fissure  or  anal  ulcer  is  present  the 
pain  is  in  proportion  to  its  size  and  the 
general  aggravation  of  all  the  diseased 
parts.  Itching  or  pruritus  about  the  anus 
may  accompany  the  trouble  to  a  very 
annoying  extent,  being  an  evidence  that 
the  anal  pockets  are  becoming  much  dis- 


Abnormal  Cavities 

eased.  The  partially  constricted  and  ir- 
ritable sphincter  muscles  become  excited 
during  the  act  of  stooling  and  react  on 
the  anal  grip  or  contraction,  making  it 
more  intense.  This  latter  condition  may 
shut  off  the  flow  of  blood  in  a  local  vein  ; 
and  the  blood  becoming  coagulated  forms 
a  painful  bluish  grape-like  tumor  at  the 
external  opening  of  the  anus. 

Abscesses  may  form  at  some  portion 
of  the  diseased  gut  and  result  in  an  ex- 
ternal fistula. 

Piles  may  co-exist  in  some  cases  of 
ballooning,  but  are  usually  not  annoying. 

It  is  the  local  anal  or  external  annoyan- 
ces that  compel  the  sufferer  to  seek  medi- 
cal advice  and  aid,  and  he  learns  that 
the  troubles  complained  of  are  only  symp- 
toms of  a  chronic  disease,  therefore  easily 
removed  without  harsh  treatment  while 
the  cause  is  being  properly  cured. 

It    is    very   fortunate    for    the    sufferer 

from  ballooning  of  the  rectum  to  have  in 

or  near  the  anal  canal  those  painful  hints 

or  symptoms   of  a  very  grave  and  long 

123 


Intestinal  Ills 

existing  disease  whose  constitutional  symp- 
toms were  well  marked  but  attributed  to 
other  causes,  especially  to  disease  of  the 
liver — an  organ  of  so  much  solicitude  that 
the  poor  liver-worshipping  patient  ought 
to  receive  more  gracious  response  from  it. 

In  every  case  of  chronic  proctitis,  or 
inflammation  of  the  anus  and  rectum,  the 
sigmoid  flexure  must  be  more  or  less 
dilated,  as  the  upper  part  of  the  rectum 
is  very  irritable  and  contracted  and  in- 
hibits the  feces  from  passing  beyond  the 
sigmoid ;  but  this  irritability  and  contrac- 
tion of  the  rectum,  as  a  rule,  is  not  nearly 
so  severe  as  that  of  the  anal  canal,  whose 
orifice  is  closed  by  very  strong  sphincter 
muscles. 

Such  being  the  pathological  change  in 

the  sigmoid  flexure  and  especially  in  the 

lower  portion  of  the  rectum,  as  described 

in  these  two  chapters,  who,  with  ordinary 

intelligence   and    an    idea  of    cleanliness, 

would  take  or  prescribe  remedies  to  move 

the  bowels,  if  it  were  possible  to  cleanse 

the  foul   capacious  cavities  with   water  ? 

124 


Abnormal  Cavities 

We  know  that  they  can  be  thus  cleansed, 
and  that  it  can  be  easily  accomplished 
with  benefit  to  the  diseased  canals. 

After  the  system  has  absorbed  75 
per  cent  of  the  fecal  mass,  a  "  remedy " 
is  taken  to  excite  a  flow  of  watery  ex- 
cretions into  the  bowels,  of  which  a 
portion  will  be  retained  in  the  colon,  and 
especially  the  ballooned  cavities,  and  re- 
absorbed ;  and  every  day  the  objection- 
able practice  is  repeated  without  any 
thought  of  the  harm  being  done. 

The  flushing  of  the  rectum,  sigmoid 
flexure  and  colon  with  water  is  not  a 
cure-all,  but  it  is  one  of  the  means  of 
treating  a  grave  chronic  disease,  a  dis- 
ease insidious  and  far-reaching  in  its  poi- 
sonous  effects   on  the  human  organism. 


"5 


CHAPTER  XVI. 

THE    USUAL   DIAGNOSIS    AND    TREATMENT    OF 
BOWEL  TROUBLES   WRONG. 

HERODOTUS  tells  us  that  among 
certain  tribes  when  a  man  fell  sick 
his  next-door  neighbor  did  not  Avait  for 
him  to  become  thin  but  killed  him  at 
once,  lest  by  the  loss  of  his  adipose  his 
flesh  might  be  rendered  less  appetizing. 

But  alas  !  in  this  age  of  constipation 
and  piles,  of  self-generated  poisons  and 
self-infection,  how  changed  is  the  custom  ! 
Our  next-door  neighbor,  the  doctor,  waits 
till  we  are  really  thin,  and  then  begins  to 
feed  and  grow  fat  on  our  ills  !  In  our 
day,  through  the  continuous  process  of 
self-poisoning  we  take  on  no  flesh  from 
puny,  peaked  childhood,  or  we  insidiously 
lose  what  little   flesh  we  had,   and  when 

our    bones     are    well    exposed,    become 

126 


Emaciation  and  Anemia 

alarmed,  realize  that  we  are  sick,  rush 
for  the  doctor,  and  dispossess  ourselves 
of  our  spare  cash. 

Very  frequently,  as  stated  in  the  first 
chapter,  auto-infection  begins  in  infancy 
and  slowly  but  steadily  progresses,  but  it 
may  not  be  before  adult  age  is  reached 
and  one  or  more  organs  are  seriously  dis- 
eased that  it  becomes  apparent  to  all. 
The  vital  round  of  the  alternate  building- 
up  and  breaking-down  of  the  system  has 
been  going  on  unceasingly  during  these 
years  of  increasing  infection,  but  prema- 
turely the  balance  between  up  and  down 
is  lost  in  favor  of  down  ;  the  building- 
up  process  becoming  feebler,  slower, 
and  the  breaking-down  process  quicker, 
easier.  What  can  the  inevitable  out- 
come be  but  emaciation  and  anemia, 
and  all  their  attendant  sufferino-  and  con- 
sequences  ?  It  is  the  superabundance  of 
vitality  in  the  growing  child  that  retards 
(inhibits)  the  morbid  changes  going  on  in 
the  blood  and  tissues  of  the  system ;  but 

the   process  is  all  the  more  insidious  by 
127 


Intestinal  Ills 

being  thus  restrained,  and  its  very  sub- 
tlety and  stealth  beguile  us  all  into 
fancied  security  :  parents,  friends,  phy- 
sicians— all  are  deceived. 

As  stated  in  a  previous  chapter,  the 
first  unwelcome  visitor,  in  infancy,  is  in- 
flammation of  the  integument  and  mucous 
membrane  of  the  anal  orifice,  invited  by 
the  uncleanliness  involved  in  the  use  of 
diapers  ;  and  this  visitor  takes  up  its  resi- 
dence slowly  along  several  inches  of  the 
lower  bowel.  Its  first  symptoms  are  likely 
to  be  constipation,  flatulency,  colic,  indi- 
gestion, bacterial  and  other  poisons,  occa- 
sionally diarrhea,  and  the  usual  general 
disturbance  of  the  system  as  above  de- 
tailed. It  is  admitted  by  all  authors  that 
inflammation  of  the  anus,  rectum,  etc.,  is 
by  far  the  most  common  disease  that  af- 
flicts mankind  at  all  ages  ;  and  I  main- 
tain that  the  natural  result  of  such 
inflammation  is  a  more  or  less  extensive 
occlusion  of  the  lower  bowel,  which  in 
turn  involves  an  undue  retention  of  the 

feces,  and  thus  we  have  the  foul  intestinal 

128 


Emaciation  and  Anemia 

canal  and  stomach  called  gastric  and  in- 
testinal indigestion. 

The  wrong  treatment  of  constipation, 
diarrhea,  indigestion  and  auto-intoxica- 
tion up  to  the  present  time  has  been  due 
to  improper  diagnosis.  Writers  on  these 
subjects  speak  of  them  as  causes  when 
they  are  merely  symptoms.  And  the 
remedies  for  these  "  causes "  are  even 
more  numerous.  Mistaken  diag?iosis  on 
the  one  hand,  measured  doses  on  the  other, 
and  there  you  have  the  scientific  doctor ! 
The  primary  cause,  inflammation,  like  the 
original  spark  applied  to  dry  shavings, 
sets  up  morbid  changes  in  the  various 
parts  of  the  digestive  canal  and  the  other 
organs  of  the  body,  and  these  "  set  up " 
or  established  changes  are  properly  sec- 
ondary or  derivative  causes  accompanied 
by  their  own  symptoms.  The  primary 
disease  and  symptoms  may  exist  for  five, 
ten,  twenty  or  more  years  before  any 
pronounced  secondary  or  derivative  dis- 
eases and  their  symptoms   occur  or  are 

noticeable  to  a  sufficiently  marked  degree. 
129 — 9 


Intestinal  Ills 

The  chronic  character  of  the  malady, 
and  the  complication  of  primary  with 
secondary  diseases  and  their  symptoms, 
have  thoroughly  disconcerted  the  doctors. 
Hence  the  many  "causes"  assigned  for 
indigestion,  constipation,  etc.,  and  the 
many  kinds  of  remedies  prescribed  with 
the  one  sure  result,  failure  ;  and  hence, 
also,  not  a  few  of  the  self-  and  drug-intoxi- 
cated ones  dubbed,  or  actually  developed 
into,  hypochondriacs.  Diagnosis  wrong, 
treatment  wrong,  failure  certain,  and  the 
foulness  of  the  intestinal  canal  continued  ! 
This  is  the  experience  and  testimony  of 
the  many,  many  sufferers  from  the  most 
common  malady  that  afflicts  humanity 
from  infancy  to  old  age,  and  which  will 
continue  to  afflict  the  great  majority  until 
it  is  properly  understood  and  treated. 

When  a  sewer  of  a  town  is  obstructed, 
the  most  sensible  plan  is  to  begin  the  in- 
vestigation at  the  outlet  and  then  proceed 
up,  section  after  section,  to  trace  the  ob- 
stacle that  had  occasioned  the  accumula- 
tion of  debris.     When  the  waste-pipes  of 

130 


Emaciation  and  Anemia 

a  house  are  clogged,  we  do  not  expect  the 
plumber  to  go  to  the  top  of  the  building 
and  poke  substances  down  the  pipe  to  dis- 
lodge the  unduly  retained  material  some 
twenty-five  feet  or  more  away.  Nor 
would  we  believe  him  if  he  informed 
us  that  the  sewer-gas  and  overflow  of 
waste  in  the  house  were  the  catise  of  the 
constipated  condition  of  the  drain.  But 
just  this  is  what  the  doctor  declares  con- 
cerning our  sewer ;  just  this  is  what  he 
does  when  he  doses  it  with  laxatives, 
cathartics,  purgatives.  Such  is  the  treat- 
ment we  receive  when  we  rush  to  the 
doctor,  or  such  the  treatment  we  give  our- 
selves. The  poor,  sensitive,  inflamed 
canal  is  desecrated  on  all  hands,  though 
part  of  a  house  not  made  with  hands — a 
house  that  should  be  a  home  for  the  soul 
of  man. 


131 


CHAPTER  XVII. 

COSTIVENESS. 

THE  words  constipation,  obstipation 
and  costiveness  are  often  employed 
as  if  of  exactly  similar  meaning,  but  it  is 
well  to  let  each  stand  for  a  particular  con- 
dition. Obstipation  implies  that  the  canal 
of  the  intestine  is  stopped  up  or  closed. 
Constipation  carries  the  idea  that  the  canal 
is  completely  filled  up  with  refuse  matter. 
In  the  normal  condition  the  intestine  is 
divided  by  transverse  bulges  or  valves  or 
dams  into  a  number  of  separate  segments, 
the  entire  arrangement  having  the  effect  of 
preventing  too  rapid  descent  of  the  feces. 
These  folds  within  the  canal  may  be- 
come too  much  narrowed  by  disease  and 
thus  prevent  the  movement  of  the  mat- 
ters inside ;  this  is  obstipation.  Consti- 
pation,  stuffing  of  the  gut,    may  be  the 

132 


Stages  of  Auto-Intoxication 

result  of  neglecting  the  call  of  nature, 
and  after  a  time  the  ability  to  recognize 
and  answer  it  is  lost  ;  or  it  may  result 
from  inflammation  which  itself  comes  from 
the  bad  habit  mentioned. 

The  author  prefers  to  use  the  term  cos- 
tiveness  for  the  general  debased  condition 
of  the  system  from  auto-intoxication  de- 
pending upon  proctitis  and  similar  condi- 
tions of  the  intestinal  tract.  And  it  must 
be  remembered  that  the  same  patient  may 
haye  two  or  more  of  these  conditions  at 
the  same  time.  Constipation,  obstipation 
and  diarrhea  may  alternate  through  the 
progress  of  the  case. 

We  would  expect  people  suffering  from 
constipation  or  obstipation  to  pass  as 
fairly  well  people  for  a  time,  but  the 
same  is  not  true  of  patients  having  the 
other  condition,  costiveness.  As  we  may 
speak  of  the  stages  of  a  disease  like  con- 
sumption, so  we  may  speak  of  these  three 
conditions  as  different  stages  of  one  affec- 
tion, the  worst  being  costiveness  with  its 
progressive     self-poisoning     by    the   pro- 

133 


Intestinal  Ills 

ducts  of  intestinal  decomposition.  Early 
in  the  case  the  system  may  pass  these 
poisons  out  of  the  body  with  comparative 
ease,  by  way  of  the  lungs,  skin  and  kid- 
neys. In  time  the  second  stage  begins 
to  make  itself  apparent,  vitality  becomes 
less  and  less,  calling  for  a  greater  variety 
of  medicines  to  correct  the  condition,  as 
in  the  second  stage  of  consumption,  and 
also  to  arrest  the  progress  of  emaciation 
and  anemia  or  anemic  obesity. 

The  third  stage  of  auto-intoxication  is 
a  most  unhappy  one.  The  impoverished 
tissues  offer  a  most  favorable  soil  for 
the  development  of  diseased  conditions. 
These  three  stages  which  are  clear  to  the 
experienced  eye  of  the  physician  may  to 
the  patient  seem  to  be  indistinguishable, 
the  one  from  the  other  ;  and  it  must  not 
be  forgotten  that  the  three  conditions  do 
not  mean  simply  that  a  smaller  or  larger 
part  of  the  intestine  is  clogged  by  its  con- 
tents, but  that  the  whole  system  is  in- 
volved as  well. 

It  cannot  indeed  be  otherwise  with  the 

134 


Stages  of  Auto-Intoxication 

rapid  circulation  of  the  blood,  nor  need  it 
excite  wonder  that  such  patients  are  thin 
and  debilitated  by  the  deadening  of  the 
powers  of  absorption,  assimilation  and 
elimination. 

As  a  rule  the  many  thin  and  puny  in- 
fants and  children  of  either  sex,  with 
bony  points  well  exposed  under  a  tightly 
drawn  skin,  which  latter  is  clay-colored 
and  pimply  ;  children  with  headache  and 
languor,  without  healthy  interest  in  either 
studies  or  play  ; — these  are  the  victims  of 
intestinal  poisoning  as  described.  If  they 
have  inherited  a  spare  habit  of  body  from 
their  parents  such  bodily  ills  will  mani- 
fest themselves  the  more  quickly.  They 
ought  to  be  fat  and  hearty  as  are  the 
young  of  animals,  but  alas  many  are  not ! 
When  the  young  animal  is  spare,  a  few 
days  of  rest  with  good  diet  will  put  flesh 
on  it,  demonstrating  that  the  state  of  the 
bowels  and  the  powers  of  assimilation 
are  intact.  Why  does  not  man  take  on 
flesh  in  a  similar  way  ? 

If  the  intelligent  animals  could  talk, 
135 


Intestinal  Ills 

they  would  undoubtedly  make  all  manner 
of  fun  of  the  intestinal  canals  which  they 
see  walking  about,  with  a  little  flesh  here 
and  there  seemingly  by  accident,  and  a 
skin  which  is  clay-colored  or  jaundiced, 
anemic  or  flabby,  the  owner  of  it  all  poi- 
soning himself  by  decomposition  in  his 
intestines  1 


136 


CHAPTER  XVIII. 

INFLAMMATION. 

IF  we  desire  to  get  a  general  idea  of  the 
changes  that  occur  in  an  organ  when 
it  becomes  inflamed,  we  must  first  have  a 
knowledge  of  the  normal  structure  of 
that  organ,  even  though  that  knowledge 
be  but  superficial.  Taking  the  intestines, 
for  example,  we  see  under  the  micro- 
scope that  they  are  composed  of  layers 
of  different  tissues,  called  connective, 
epithelial,  muscle,  and  nerve  tissue  ;  the 
first  two  forming  a  large  part  of  the 
structure. 

In  the  connective  (and  fatty)  tissues 
a  great  many  blood-vessels  are  found 
(varying  in  different  parts  of  the  organ), 
the  existence  of  which  is  necessary  for  the 
production  of  inflammation,  since  at  the 
very  outset  of  the  process,  a  discharge 
(or  exudation)  takes  place  from  these 
137 


Intestinal  Ills 

blood-vessels,  accompanied  by  changes  or 
degenerations  in  the  other  kinds  of  tissue. 

The  process  of  inflammation  is  com- 
monly associated  with  symptoms  of  heat, 
redness,  swelling  and  pain,  in  greater  or 
less  degree,  combined  with  which  a  change 
in  the  function  of  the  orran  is  soon 
noticed.  Micro-organisms  are  considered 
the  primary  cause  of  inflammation  in 
many  or  even  in  most  cases  in  which 
mechanical  or  chemical  influences  may 
undoubtedly  be  responsible  primarily  ;  and 
then  again,  each  of  these  causes  may  be 
either  external  —  that  is,  may  originate 
from  the  outside  world  —  or  internal,  that 
is,  may  be  produced  in  and  by  the  body 
itself. 

The  first  pronounced  change  occurring 
in  an  or^an  under  inflammation  is  an 
increase  in  the  rapidity  with  which  the 
blood  circulates  through  the  vessels  — 
a  so-called  hyperemia  —  which  soon  gives 
place  to  a  diminution  (stasis)  in  the 
current  together  with  an  exudation  from 
the   blood-vessels ;   the    latter    is    due    to 

138 


Inflammatory  Changes 

changes  in  the  structure  of  their  walls. 
This  exudation  soon  occasions  a  cloudi- 
ness of  the  connective  tissues  and  at  the 
same  time  a  desquamation  (^shedding  in 
scales)  of  the  epithelia  (cells  of  the  thin 
mucous  surface).  An  irritation  of  the 
nerves  also  takes  place. 

The  varieties  of  inflammation  can  be 
best  apprehended  by  considering  the  dif- 
ferent characters  of  the  exudation.  The 
exudation  may  be  watery  (^called  serous) 
or  dense,  the  latter  either  fibrinous  or 
albuminous.  With  a  serous  exudation 
there  is  swelling  of  the  connective  tissue 
and  a  desquamation  of  epithelia  —  the 
latter  usually  slight  in  character  —  which 
constitutes  what  is  known  as  a  catarrh  ; 
while  with  a  fibrinous  or  albuminous 
exudation  there  is  usually  more  or  less 
destruction  of  the  tissue  itself,  when, 
for  example,  we  have  "  croup  "  or 
"  diphtheria." 

When  the  changes  in  the  epithelia  are 

only  slight  and  secondary,  it  is  spoken  of 

as  an  interstitial   (lying  between)  inrlam- 
139 


Intestinal  Ills 

mation,  which  strictly  speaking  denotes 
confined  to  connective  tissue,  and  is 
therefore  a  term  not  entirely  correct. 
When  the  inflammation  of  the  epithelia 
is  severe  and  may  lead  to  their  partial 
destruction,  it  is  called  a  parenchymatous 
inflammation  ;  that  is,  one  involving  the 
soft  cellular  substance.  There  is  still 
another  variety,  the  suppurative,  which  is 
the  most  intense  of  all,  and  indicates  the 
production  of  an  abscess  and  the  entire 
destruction  of  the  tissue  implicated. 

Beside  these  general  grades  of  inflam- 
mation there  are  special  sorts  produced 
by  specific  micro-organisms.  In  all  general 
inflammation  we  may  expect  to  find  such 
organisms,  which  in  most  cases  belong 
to  the  class  of  micrococci,  such  as  staphy- 
lococci and  streptococci.  In  gonorrhea  we 
have  a  special  organism  called  the  "gono- 
coccus  "  ;  while  in  tuberculosis  —  a  variety 
of  inflammation  in  which  the  blood-vessels 
are  completely  destroyed  and  a  change  or 
degeneration  called  "  cheesy  "  is  produced, 

leading  to  the  production  of  a  tubercle — ■ 

140 


Inflammatory  Changes 

a  rod-like  bacillus  is  invariably  found,  the 
well-known  and  unfortunately  too  common 
tubercle  bacillus.  In  syphilis  —  another 
special  variety  of  inflammation  —  a  specific 
micro-organism  is  also  surely  present,  but 
of  this  microbe  science  has  not  as  yet  dis- 
covered the  exact  nature. 

The  question  of  the  origin  of  tumors 
or  new  growths  is  also  an  extremely  im- 
portant one  ;  and  it  is  undoubtedly  true 
that  many  tumors  arise  where  there  was 
a  previous  inflammation,  this  being  espe- 
cially the  case  in  tumors  of  the  rectum. 
Why  such  a  growth  should  arise  in 
some  cases  and  not  in  others  is  as  yet 
unknown,  though  microbes  are  held  by 
many  to  play  an  important  role. 

When  an  inflammation  has  lasted  for 
such  a  length  of  time  that  it  has  become 
chronic,  a  new  tissue  will  sooner  or  later 
be  produced  in  varying  amount ;  and  this 
newly  formed  fibrous  connective  tissue 
may  entirely  replace  previous  normal 
structures.  Through  the  exudation  and 
consequent  changes  in  the  normal  tissue 

141 


Intestinal  Ills 

alarofe  amount  of  mucus  is  at  first  secreted, 
but  this  secretion  becomes  less  and  less 
marked  the  more  the  inflammation  causes 
a  desquamation  of  the  epithelia.  Pro- 
nounced desquamation  with  new  forma- 
tion of  connective  tissue  and  no  fresh 
exudation  will,  sooner  or  later,  occasion 
dryness  —  this  dryness  being  sometimes 
very  pronounced.  The  longer  the  inflam- 
mation lasts,  the  severer  it  will  be  ;  and 
the  greater  the  amount  of  tissue  it  attacks, 
the  more  will  the  normal  tissue  be  de- 
stroyed and  replaced  by  a  new  connective 
tissue.  A  partial  destruction  will  cause 
shrinkage  of  the  organ  (so-called  "cirrho- 
sis ")  ;  while  a  complete  destruction  of 
certain  parts  will  result  in  what  is  known 
as  "  atrophy  "  (a  wasting  away  of  normal 
tissue).  In  atrophy  the  blood-vessels  as 
well  as  the  original  connective  and  epi- 
thelial tissue  are  destroyed;  while  the 
newly  formed  tissue  leads  to  hypertrophy 
(excessive  over-growth)  of  other  portions 
of  the  organ.     Such  a  hypertrophy  must 

not  be  confounded  with  an  induration  that 

142 


Inflammatory  Changes 

may  be  present  later,  or  even  at  the  very 
commencement  of  an  inflammation,  due 
to  modification  of  the  blood-vessels  and 
surrounding  tissues. 

Chronic  inflammation,  sooner  or  later, 
leads  to  secondary  degenerations,  that  is, 
new  products  of  the  protoplasm,  the  most 
common  of  which  is  fatty  degeneration. 
In  this  form  fat  granules  and  globules 
arise,  which  are  at  first  minute,  later  on 
larger  ;  these  in  certain  organs,  such  as  the 
liver,  may  become  so  pronounced  as  to 
entirely  replace  the  original  tissue.  An- 
other degeneration — which,  however,  is 
found  only  in  chronic  systemic  disturb- 
ances, such  as  tuberculosis  or  syphilis — is 
the  waxy  or  amyloid  degeneration,  a  pecul- 
iar chemical  change  the  exact  nature  of 
which  is  unknown. 

Various  chemical  changes  are  by  no 
means  uncommon. 

An  important  question  is  the  decision 
as  to  the  length  of  time  an  inflammation 
has  lasted  ;  and  this  at  best  can  be  deter- 
mined only  approximately  and  after  long 
143 


Intestinal  Ills 

experience.  The  older  the  inflammation, 
the  more  the  connective  tissue  has  de- 
veloped ;  this  connective  tissue  is  at  first 
soft,  but  soon  becomes  more  and  more 
dense ;  the  result  being-  a  varying  degree  of 
hardness  of  the  organs. 

Again,  secondary  degenerations  are 
more  pronounced  in  long-standing  pro- 
cesses. In  comparatively  fresh  cases 
blood-vessels  are  still  more  or  less  numer- 
ous and  the  tissue  appears  red,  while  in 
older  cases  these  vessels  become  com- 
pletely obliterated,  and  the  tissues  take 
on  a  white,  glistening  color,  becoming- 
harder  and  denser  as  the  years  advance. 
If  a  process  has  lasted  twenty  or  thirty 
years,  the  changes  to  the  eye  and  touch  are 
practically  the  same  as  after  forty  or  sixty 
years. 

The  changes,  as  here  described,  will  be 
the  same  upon  any  mucous  membrane  ; 
and  in  the  large  intestine  can  be  easily 
studied  and  are  perfectly  characteristic. 

Rarely  does  an  infant  escape  repeated 
attacks  of  inflammation  of  the  integument 

144 


Inflammatory  Changes 

of  the  anus  and  the  mucous  membrane  of 
the  anal  canal.  The  inflamed  integument 
is  treated  and  healed,  but  no  attention  is 
oqven  to  the  inflamed  mucous  membrane 
so  that  the  inflammation  in  time  becomes 
chronic,  involving  the  rectum  also.  Should 
the  infant  be  so  fortunate  as  to  escape  in- 
flammation (proctitis)  of  these  organs 
during  the  wearing  of  the  diaper,  there 
are  numerous  other  exciting  causes  of  in- 
flammation which  it  will  not  be  likely  to 
escape,  hence  the  almost  universal  symp- 
tom of  constipation  among  civilized  peo- 
ple ;  and  hence  later  in  life  you  hear  the 
familiar  expression,  "  I  have  a  touch  of 
the  piles,"  and  many  other  complaints  of 
bowel  ailments  that  are  usually  the  out- 
come of  that  deplorable  inflammation. 

I  have  endeavored  to  make  clear  the 
fact  that  inflammation  destroys  normal 
tissues  and  blood-vessels,  and  that  the 
newly  formed  tissue  is  cicatricial  in  charac- 
ter, that  is  poor  in  cells  and  vessels,  with 
a  tendency  to  contraction  which  of  course 

lessens  the  bore  of  the  gut.     When  the 
145—10 


Intestinal  Ills 

hypertrophy  or  thickening  is  extensive 
the  appearance  of  the  mucous  membrane 
suergfests  the  addition  of  one  or  more 
thicknesses  of  a  chamois  skin  added  to 
the  inner  surface  of  the  anal  and  rectal 
canals.  The  hypertrophied  or  newly 
formed  tissue  may  be  limited  to  the 
rectum,  leaving  the  anal  tissues  compar- 
atively exempt  from  the  superabundant 
cicatricial  formation  ;  or  the  hypertro- 
phy may  involve,  to  quite  a  degree,  only 
the  anal  tissues  and  the  integument 
around  the  anal  orifice.  The  added  con- 
nective tissue  about  the  anus  forms  the 
skin  into  tabs,  or  into  a  circle  of  elongated 
internment  around  the  orifice,  with  a 
mucous  lining.  These  hypertrophied  tabs 
or  folds,  like  pruritus  ani,  are  symptoms 
of  proctitis. 

Proctitis  (the  inflammation  of  the  anal 
and  rectal  canals)  is  the  most  common 
and  serious  disease  that  afflicts  man.  The 
system  is  not  only  poisoned  by  bacteria 
and  filth  through  proctitis,  but  proctitis  is 

also  the  cause  of  the  many  annoying  and 

146 


Inflammatory  Changes 

painful  local  symptoms,  such  as  hypertro- 
phy, piles,  abscess,  fistula,  cancer,  polypus, 
fissure,  pruritus,  etc. 

When  the  subject  of  proctitis  is  better 
understood  by  laymen  they  will  see  to  it 
that  the  rectums  of  children  receive  an 
examination  before  the  children  are  six 
years  old,  and  thus  obviate  the  necessity 
of  dosing-  them  with  all  sorts  of  medicine 
that  follow  improper  diagnosis. 


147 


CHAPTER  XIX. 

PROCTITIS  AND   PILES. 

PILES  (hemorrhoids)  are  not  the  result 
,  of  either  the  normal  or  abnormal 
growth  of  the  tissues  of  the  anal  and  rectal 
mucous  membrane.  They  are  developed 
by  the  combination  of  pathological  and 
physiological  conditions:  (i)  chronic  in- 
flammation or  proctitis  ;  (2)  stricture  of 
the  anal  canal  and  lower  portion  of  the 
rectum,  which  may  be  spasmodic,  or  more 
or  less  permanent,  which  stricture  pinches 
or  constricts  the  canal,  thereby  inhibiting 
the  circulation  of  the  blood  ;  (3)  the  press- 
ure or  straining  effort  during  the  act  of 
defecation,  occasioned  by  the  constricted 
canal,  which  effort  brings  on  greater  local 
congestion  and  constriction  of  the  tissues. 
Pile  formations  are  a  symptom  of 
chronic  proctitis  of  fifteen,  twenty  or  more 

years  duration.      Proctitis  (inflammation 

148 


Proctitis  and  Piles 

of  the  anus  or  rectum)  and  periproctitis 
(inflammation  of  the  connective  tissue 
about  the  rectum)  are  by  no  means  un- 
common inflammatory  processes.  The 
mucous  membrane  like  the  skin  is  liable 
to  injury  or  poisons  and  especially  so  at 
the  orifices  of  the  body.  Let  inflammation 
set  in  :  if  it  be  not  cured  at  once,  it  will 
invade  the  canal,  especially  a  canal  like  the 
rectum  ;  in  which  case  it  will  establish  it- 
self throughout  from  six  to  ten  inches  of  its 
length,  sometimes  taking  in  the  sigmoid 
flexure  and  even  the  colon.  Just  how 
long  chronic  inflammation  confines  itself 
to  the  mucous  membrane  before  invading 
the  areolar  or  lace-like  connective  tissue 
and  the  muscular  tissue  of  the  organ,  I  am 
unable  to  state. 

The  first  symptom  or  indication  that  all 
the  tissues  are  involved  in  the  inflam- 
matory process  will  most  naturally  be 
constipation.  You  have  observed  that 
inflammation  of  a  portion  of  the  skin  on 
the   arm,   trunk  or  leg  does  not  disturb 

the  muscular  movements  of   the   region 
149 


Intestinal  Ills 

involved,  except  when  the  muscles  under- 
neath the  skin  are  affected  also,  as  in  the 
case  of  deep  burns  where  the  movements 
are  very  much  disturbed  by  the  irritability, 
soreness  and  contraction  of  the  diseased 
muscles.  There  is  also  an  adhesive  pro- 
duct excreted  from  the  inflamed  tissue 
that  binds  the  muscular  fibres  of  an  oroan 
together,  and  you  have  contraction  of  the 
organ  and  its  usefulness  impaired.  Now,  as 
this  is  precisely  the  pathological  or  dis- 
eased condition  which  chronic  cases  of 
proctitis  and  periproctitis  present,  you  will 
readily  understand  how  spasmodic  and 
partial  stricture  or  contraction  occurs  in 
the  sore  muscles  (circular  and  longitudinal) 
of  the  anus  and  rectum.  The  length  and 
the  bore  of  the  canal  are  diminished,  and 
thus  the  circulation  of  the  blood  arrested 
by  the  pressure  or  gripping  of  the  con- 
tracted muscles.  This  congestion  of  the 
blood  brings  about  an  anatomical  change 
in  the  structure  of  the  mucous  membrane, 
which  we  call  piles  :  a  mere  symptom  of 

inflammation. 

150 


Proctitis  and  Piles 

Medical  authors  have  defined  inflam- 
mation as  follows  :  "  (i)  A  series  of 
changes  constituting  the  local  reaction  to 
injury  ;  (2)  a  series  of  changes  that  con- 
stitute the  local  attempt  at  repair  of  actual 
or  referred  injury  of  apart;  (3)  a  series 
of  local  phenomena  that  are  developed  in 
consequence  of  primary  lesion  of  the 
tissues  and  that  tend  to  heal  these  lesions  ; 
(4)  the  method  by  which  an  organism  at- 
tempts to  render  inert  the  noxious  ele- 
ments introduced  from  without  or  arising 
within  it ;  (5)  a  disturbance  of  the  mech- 
anism of  nutrition  of  an  organ  or  tissue, 
affecting  the  structures  concerned  in  its 
function." 

These  effects  or  changes  give  rise  to 
the  five  cardinal  symptoms  of  inflamma- 
tion :  pain,  heat,  redness,  swelling  and 
impaired  function  (dolor,  calor,  rubor, 
tumor,  functio  laesa). 

Proctitis  may  exist  many  years  before 
the  pain  and  heat  become  noticeable  or 
are  complained  of  by  the  victim  of  this 
insidious  disease,  the  bodily  symptoms  of 

151 


Intestinal  Ills 

which  are  well  expressed  before  the  local 
trouble  demands  attention  and  treatment. 
The  sufferer  from  proctitis  is  unable  to 
detect  the  chancre  from  a  normal  color  of 
the  mucous  membrane  (a  light,  muddy 
gray)  to  an  extremely  abnormal  one  (a 
fiery  redness).  The  swelling  or  puffiness 
of  the  mucous  membrane  becomes  more 
marked  as  repeated  attacks  of  subacute 
and  acute  inflammation  occur,  from  year 
to  year,  over  a  period  of  twenty  or  more 
years.  During  all  this  time  impairment 
of  the  function  and  structure  of  the  anal 
and  rectal  canals  is  incessantly  going  on. 
The  nervous  and  muscular  spasmodic  con- 
traction of  the  diseased  anus  and  rectum, 
which  in  time  become  more  or  less  per- 
manently constricted,  steadily  increases 
the  stagnation  and  engorgement  of  blood 
in  the  dilated  arteries,  veins,  arterioles, 
venous  rootlets  and  capillaries.  All  of  the 
circulatory  vessels,  especially  the  smaller 
ones,  become  enlarged,  varicose  ;  and  an 
aggregation    of    varicosed    vessels    forms 

a   tumor   called   a  pile    or    hemorrhoid. 

15a 


Proctitis  and  Piles 

Inflammation  interferes  with  nutrition  of 
the  anal  and  rectal  tissues,  rendering  them 
friable  or  weak  and  easily  broken  ;  whence 
the  bleeding  and  painful  fissure  or  the 
anal  ulcer,  which  so  often  are  the  outcome 
of  proctitis  and  an  accompaniment  of 
piles. 

As  already  stated,  piles  are  one  of  the 
symptoms  of  proctitis,  and  all  cases  of 
piles  involve  more  or  less  irritability  and 
contraction  of  the  anal  canal  and  the  ter- 
minal portion  of  the  rectum  through 
which  the  fecal  matter  is  forced.  All  the 
muscular  ability  of  the  rectum,  assisted  by 
straining  effort  of  the  abdominal  muscles, 
is  concentrated  upon  the  feces  to  force  it 
through  the  constricted  portion  of  the 
lower  bowel.  The  force  exerted  not  only 
develops  pile  tumors,  but  carries  out  with 
the  feces  those  tumors  that  had  reached 
considerable  proportions  ;  thus  the  frail 
diseased  mucous  membrane  is  torn,  and 
another  symptom  added  to  a  chronic  dis- 
ease. Observation  for  over  twenty  years 
has  convinced  me  that  chronic  proctitis 
153 


Intestinal  Ills 

usually  exists  fifteen,  twenty  or  more 
years  before  piles  are  developed  (if  de- 
veloped at  all),  from  daily  pressure  on 
the  inflamed,  congested,  dilated,  vari- 
cose, friable  blood-vessels  and  surround- 
ing tissue. 

Piles  are  easily  and  quickly  cured  with- 
out any  annoyance  to  the  sufferer. 
Chronic  proctitis  may  be  cured,  but  not 
quickly,  as  time  is  required  to  undo  dam- 
age to  tissues  so  long  invaded  by  inflam- 
matory process.  Any  one  that  allows  a 
continuance  of  "  a  touch  of  the  piles," 
as  the  expression  is,  and  omits  to  take 
proper  treatment  as  soon  as  this  "  touch  " 
is  felt,  simply  invites  or  takes  chances  of 
some  form  of  cancer  of  the  lower  bowel 
later  in  life. 

All  other  forms  of  disease  of  the  lower 
bowel  will  yield  to  treatment  satisfactory 
to  physician  and  patient,  but  I  am  sorry  to 
say  cancer  cases  are  numerous,  and  up  to 
the  present  time  we  have  no  cure  for  this 
dreadful  disease.  If  you  value  health,  if 
you  desire  to  avoid  future  suffering  and 

154 


Proctitis  and  Piles 

disease,  be  sure  that  the  lower  bowel  is 
free  from  inflammation,  for  with  such  free- 
dom you  will  escape  the  many  symptoms 
of  proctitis  described  in  my  treatise  on 
diseases  of  the  anus  and  rectum. 


155 


CHAPTER    XX. 

PRURITUS  OR  ITCHING  OF  THE  ANUS. 

ONE  of  the  many  symptoms  of  proc- 
titis is  the  existence  of  anal  chan- 
nels front  which  an  inflammatory  product 
exudes  through  the  skin,  causing  painful 
itching  of  the  skin  around  the  anal  margin 
and  not  infrequently  around  the  buttocks 
to  the  distance  of  three,  six  or  even  more 
inches  from  the  anal  orifice.  An  aggra- 
vated form  of  pruritus  ani  is  much  more 
trying  to  physical  endurance  than  severe 
pain.  Sometimes  the  torture  is  so  great 
that  a  portion  of  the  body  will  be  covered 
with  cold  perspiration. 

The  natural  color  of  the  integument 
about  the  anus  slowly  changes  to  a  dull 
whitish  appearance.  As  the  pathological 
process  goes  on,  the  skin  becomes  thick- 
ened and  parchment-like.  In  exceptional 
cases  the  mucous  membrane  of  the  anal 

156 


Pruritus  Ani 

canal  becomes  toughened  and  hardened 
like  cardboard.  As  a  consequence  there 
is  a  degree  of  inertia  in  the  muscular  ac- 
tion of  the  parts  affected. 

The  inflamed,  thickened  and  indurated 
integument  near  the  anus  takes  on  the 
form  of  folds,  wrinkles  or  rugae,  of  more 
or  less  prominence  ;  but  as  these  extend 
out  over  the  buttocks  they  become  more 
and  more  obliterated,  leaving  no  clue  to  the 
direction  of  the  channel  which  leads  from 
the  site  of  inflammation  ;  which  latter,  how- 
ever, may  be  learned  from  the  itching,  or 
from  the  burning  sensation  with  some 
soreness,  over  portions  of  their  length. 

During  a  practice  extending  over  twenty 
years,  I  have  found  only  two  cases  in 
which  one  of  these  channels  was  the  seat  of 
a  slight  abscess.  It  is  not  usual  that  pus 
formations  occur  in  these  inflammatory 
channels.  At  the  margin  of  the  opening 
from  the  rectum  to  the  anal  tube  are  five 
or  six  small  crescent-shaped  loops,  semi- 
lunar valves,  separated  by  vertical  ridges 
(the  anal  columns).     Naturally  in  chronic 

157 


Intestinal  Ills 

proctitis  the  zone  of  tissue  just  above  the 
sphincter  muscles  and  slightly  within  their 
grasp  at  the  upper  portion  of  the  anal 
tube,  would  suffer  greatly  from  the  morbid 
process,  owing  to  the  abnormal  constriction 
of  the  tissues  and  to  the  incidental  pressure 
and  injury,  from  time  to  time,  as  the  stool 
passes  the  diseased  region.  Just  under 
the  mucous  membrane  covering  the  anal 
columns  and  semilunar  valves  is  the  fatty 
tissue  forming  a  bed  upon  which  the 
mucous  membrane  rests.  It  is  sufficiently 
lax  to  permit  considerable  movement  of 
the  mucous  membrane  on  the  muscular 
coat  beneath  it.  The  frail,  fatty,  loose 
connective  tissue  in  the  grasp  of  the 
sphincter  muscles  would  be  the  first  to 
become  impaired  by  inflammatory  pro- 
cess, the  product  of  which  finds  its  way 
down  and  out  under  the  mucous  mem- 
brane of  the  anal  canal  and  integument 
of  the  buttocks  for  quite  a  distance,  occa- 
sioning itching,  pain,  soreness  or  burning 
in    the   integument  covering   the   course 

of  the  channel. 

158 


Pruritus  Ani 

Here  we  have  the  pathological  reason 
why  local  remedies  to  the  outer  surface  of 
the  skin  will  not  cure  pruritus  ani.  Also 
the  reason  why  dieting  is  useless,  and 
why  internal  remedies  are  worthless  for 
the  cure  of  anal  itching  ;  for  the  itching, 
as  shown,  is  the  result  of  an  inflamma- 
tory product  in  the  channels  under  the 
skin  of  the  victim,  numbering  from  five 
to  twenty.  Over  fifteen  years  ago  I  dis- 
covered the  cause  of  the  great  suffer- 
ing from  painful  itching  at  the  anus  and 
contiguous  tissues  and  have  been  able  to 
give  instant  relief,  and  in  a  little  time 
permanent  cure,  in  every  case  treated 
since  then.  It  is  well  for  those  who  have 
an  occasional  attack  of  pruritus  ani  to  take 
treatment  at  once  for  proctitis  proper, 
as  well  as  for  this  symptom,  itching- 
resulting  from  these  channels.  The 
proctitis,  if  neglected,  will  only  be  the 
means  of  increasing  the  size,  length  and 
number  of  these  channels.  In  chronic,  sub- 
acute and  acute  stages  of  proctitis  there 
is  more  or  less  secretion  of  inflammatory 

159 


Intestinal  Ills 

product ;  and  often  the  sufferer  is  able  to 
discover,  in  dejections  from  the  bowels,  a 
yellow  syrup-like  fluid,  of  the  consistency 
of  glycerine  or  white  of  egg,  at  times 
streaked  with  blood  and  purulent  matter 
indicating  ulceration. 

Should  the  proctitis  be  cured  and  these 
channels  remain,  there  may  be  sufficient  in- 
flammatory product  in  the  channels  to  ooze 
through  the  skin  to  the  outer  surface,  and 
excite  itching  ;  or  if  a  portion  of  the  chan- 
nel escapes  treatment,  the  same  symptom 
may  be  expected  at  any  time. 

The  size  and  length  of  these  channels  are 
best  determined  by  making  a  small  open- 
ing into  them  through  the  integument, 
then  inserting  a  silver  probe  in  both  di- 
rections, determining  the  distance  under 
the  mucous  membrane  of  the  anal  tube 
and  the  distance  under  the  skin  of  the 
buttocks. 

In  some  cases  a  few  of  these  channels 
open  into  the  rectum  just  above  the  in- 
ternal sphincter  muscles  and  become  filled 
with  water  during-  the  use  of  the  enema 

i6e 


Pruritus  Ani 

taken  to  move  and  cleanse  the  bowels. 
As  a  rule,  one  end  of  the  channel  is  under 
the  mucous  membrane  of  the  terminal 
portion  of  the  rectum,  and  the  other 
somewhere  under  the  skin  of  the  anus  or 
of  the  buttocks. 

I  presume  that  no  disease  of  the  human 
body  has  been  assigned  more  reasons  for 
its  existence,  with  the  exception  of  con- 
stipation, than  that  mere  symptom  of  a 
disease,  anal  pruritus  ;  a  symptom  which 
"  Regulars  "  call  a  "  disease,"  but  "  Irreg- 
ulars "  know  to  be  only  a  symptom.  It  is 
very  amusing  to  observe  how  they  fill 
pages  in  their  text-books,  guessing,  won- 
dering and  paying  their  respects  to  the 
imaginary  quack  doctors,  "who  are  reap- 
ing a  harvest  of  ill-gotten  gain."  The 
usual  medical  writer  is  a  compound  of  ig- 
norance, egoism  and  garrulity,  and  this 
may  account  for  the  great  crop  of  reasons 
for  "diseases."  However,  the  writers  in 
question  are  not  so  much  to  blame  after 
all,  even  though  they  do  belong  to  county 
medical  societies ;  for  how  can  they  well 

161— " 


Intestinal  Ills 

resist  the  literary  itch  with  which  most  of 
them  are  afflicted  ?  Let  them  keep  on 
writing"  while  victims  of  pruritus  ani  wear 
out  their  weary  lives  scratching  through 
weary  nights  —  nights  that  extend  into 
years,  until  permanent  invalidism  seems 
to  be  their  destiny  and  end.  Who,  verily, 
are  the  medical  quacks  ?  I  will  leave  it 
to  a  jury  composed  of  those  who  have 
been  cured  of  pruritus  ani. 

I  have  yet  to  meet  the  first-  case  of 
pruritus  ani  that  is  without  the  presence 
of  the  channels  above  described.  There 
may  be  cases  of  itching  at  the  anus 
and  these  channels  entirely  absent,  but  I 
have  yet  to  discover  such  a  case  and  I  very 
much  doubt  if  it  exists.  I  am  happy  to 
inform  the  reader  that  all  cases  of  pruritus 
ani  are  cured  with  ease  and  without  any 
restrictions  as  to  diet,  and  without  inter- 
nal remedies  for  the  blood,  nervous  sys- 
tem, etc.,  given  by  doctors  that  guess. 
The  causes  are  easily  discovered ;  the 
symptoms  are  easily  found  and  removed  ; 

the  victim  of  pruritus  ani  may  therefore 

162 


Pruritus  Ani 

escape  from  the  labyrinth  of  error  of  the 
medical  authors  and  practitioners  who 
ought  to  be  educators  instead  of  "  obsta- 
cators  "  —  obstacles  and  stumbling-blocks 
in  medical  progress. 


163 


CHAPTER  XXI. 

ABSCESS   AND    FISTULA. 

IN  our  daily  affairs  we  take  thought  for 
the  future  and  reason  from  cause  to 
effect.  We  observe,  anticipate,  expect 
and  suspect.  This  is  a  commendable 
practice,  for  it  is  the  one  that  is  most 
likely  to  lead  to  success.  Can  we  not 
acquire  a  similar  attitude  and  habit  in 
regard  to  our  health  ?  Habit  is  sub-con- 
scious  attention.  Can  we  not  give  sub- 
conscious attention  to  the  little  details  of 
such  bodily  functions  as  are  liable  to  get 
out  of  order  ?  Can  we  not  by  a  settled 
habit,  that  is,  by  the  formation  of  a  second 
nature,  assure  our  vital  success,  on  which 
the  continuance  of  the  enjoyment  of  life 
so  much  depends  ?  If  some  part  of  a 
complicated  machine  gets  out  of  order  it 
must  be  repaired  at  once  or  damage  may 

result  to  other  parts  of  it.      Again,  if  our 

164 


Abscess  and  Fistula 

business  accounts  will  not  balance,  the 
error  must  be  found  and  corrected  at 
once,  or  the  evidence  of  it  will  annoy  us 
sooner  or  later.  Why  should  not  such 
prompt  care  and  attention  be  given  to 
the  human  mechanism,  to  the  economy  of 
vital  functions  ?  It  is  not  often  that  we 
neglect  disease  of  the  hands,  head,  face 
or  neck  because  the  exposure  of  such  dis- 
ease to  public  gaze  might  embarrass  us ; 
but  alas  for  the  portion  of  the  body  out 
of  sight,  especially  for  the  internal  organs, 
when  they  fail  to  perform  their  functions 
normally.  Most  of  us  allow  the  mechan- 
ism of  the  human  body  to  shift  as  best  it 
can  and  as  long  as  it  can,  should  it  hap- 
pen to  become  ungeared,  ignoring  the 
frequent  warnings  which  the  ever  increas- 
ing morbid  changes  and  wreckage  give 
us.  And  then  we  surrender  and  succumb. 
What  else  can  we  do  ?  Our  vital  credit- 
ors file  their  claims  in  the  high  court  of 
Vital  Bankruptcy.  What  poor  business 
policy,  and  what  a  wretched  tenant !    For 

fifteen  or  more  years  we  may  have  had 
165 


Intestinal  Ills 

warning  "  touches  of  the  piles,"  sometimes 
accompanied  with  indigestion,  constipa- 
tion, diarrhea  and  insidious  auto-infection 
and  occasionally  with  local  symptoms  in 
and  around  the  anal  canal  and  its  external 
orifice  ;  these  to  an  intelligent  tenant 
should  have  been  evidence  of  proctitis,  or 
worse,  of  periproctitis  —  inflammation  of 
the  connective  tissue  of  the  rectal  tube. 
What  have  we  done  ?  We  have  disre- 
garded the  warnings  of  our  ungeared,  dis- 
ordered  machine,  or  else  we  have  merely 
tinkered  with  it.  The  human  factory  re- 
ceives less  attention  than  does  the  com- 
mercial. Soon,  all  too  soon,  the  silver 
cord  is  loosed  and  the  golden  bowl  broken, 
and  just  before  that  event,  frightened,  but 
too  late,  we  do  a  little  more  tinkering  un- 
der a  doctor's  direction,  and  spill  the  con- 
tents—  of  the  golden  bowl  with  which 
we  were  so  careless —  spill  it  into  another 
world,  to  begin  our  folly  over  again  ! 

Do  you  know  that  this  occasional 
"  touch  of  the  piles "  over  a  period  of 
many  years,  and  all  that  it  involves,  is  a 

166 


Abscess  and  Fistula 

precursor  and  an  invitation  to  the  de- 
velopment of  that  deadly  enemy,  Cancer 

—  a  worse  disaster  than  financial  ruin  ? 
It  is  my  duty  to  utter  a  warning  here. 
Only  one  making  a  specialty  of  the  dis- 
eases of  the  alimentary  canal  is  aware  of 
the  frequency  of  the  occurrence  of  cancer 
in  the  lower  bowel  resulting  from  chronic 
inflammatory  process,  induration,  etc.  I 
have  been,  again  and  again,  shocked  and 
alarmed  at  the  reckless  neglect  that  has 
brought  on  this  as  yet  incurable  disease 

—  cancer. 

These  remarks  apply  well  to  what  I 
have  to  say  on  Abscess  and  Fistula 
at  the  terminal  portion  of  the  intestinal 
canal.  It  is  the  old,  old  story  of 
being  "  touched  by  the  piles  for  many 
years,"  and  neglect,  ending  in  dread 
and  despair  at  the  necessity  of  being 
bored  full  of  holes  by  pus  seeking  an  out- 
let. The  victim  wonders  at  the  spread  of 
the  local  trouble,  and  that  an  opening  for 
the  pus  canals  has  frequently  to  be  made 

three   to   sixteen    inches   away  from  the 
167 


Intestinal  Ills 

seat  of  the  abscess.  In  a  former  chapter 
the  subject  of  proctitis  and  piles  was  gone 
into,  and  some  idea  given  of  the  invasion 
of  inflammation  in  the  rectal  and  anal 
tissues. 

In  exceptional  cases  the  exciting  cause 
of  anal  and  rectal  abscess  and  fistula,  or 
of  abscess  and  fistula  of  the  buttocks, 
may  be  a  traumatic  injury  or  accident, 
produced,  say,  by  a  blow  or  a  fall  bruising 
the  tissues,  or  by  sharp,  hard  substances 
—  such  as  pieces  of  bone  or  nutshell  — 
from  within  the  canal,  lacerating  it.  But 
wounds  of  this  character  are  very  in- 
frequent compared  with  chronic  inflam- 
mation (proctitis)  as  the  exciting  cause. 
There  are  several  varieties  of  proctitis  re- 
cognized as  the  exciting  cause  of  abscess 
and  fistula,  namely,  traumatic,  dysenteric, 
diphtheritic,  gonorrheal,  catarrhal,  etc. 
The  reader  should  not  only  pardon  me,  but 
should  be  grateful  if  by  adding  another 
name  to  the  list  I  point  out  the  most 
common  cause,  namely,  diapcr-itic  proc- 
titis.    As  pointed  out  in  the  first  chapter 

1 68 


Abscess  and  Fistula 

or  two,  the  improper  use  of  the  diaper 
will  evidence  its  deplorable  result  when 
the  period  of  manhood  or  womanhood  is 
reached,  by  some  of  the  many  symptoms 
of  proctitis. 

Proctitis  may  be  considered  as  acute, 
subacute  or  chronic  according  to  the  du- 
ration of  the  process ;  or  as  atrophic  or 
hypertrophic  from  the  structural  changes 
induced.  But  no  matter  about  the  cause 
and  character  of  the  proctitis,  the  ques- 
tion is,  Have  vou  inflamed  anal  and  rectal 
canals  ?  If  you  have,  then  the  very  an- 
noying symptom,  abscess  or  fistula,  is  lia- 
ble to  occur  any  day.  Can  you  afford  to 
take  the  chances  ? 

Just  under  the  mucous  membrane  of 
the  anus  and  rectum  there  is  a  layer  of 
loose,  fatty,  connective  tissue,  called  areo- 
lar tissue.  When  it  is  invaded  by  inflam- 
mation, abscess  and  fistula  may  occur. 
On  the  outside  of  the  rectal  wall,  at  the 
terminal  portion,  there  is  also  much  loose, 
fatty  (areolar)  tissue  filling  the  ischio- 
rectal fossa,  which  is  very  prone  to  suppu- 
169 


Intestinal  Ills 

ration,  and  inflammation  here  is  called 
periproctitis.  This  is  the  most  common 
and  serious  seat  and  source  of  the  septic 
process,  which  process  is  usually  the 
proximate  cause  of  death  after  capital 
surgical  operations  upon  the  rectum.  Be- 
side the  abundance  of  fatty  tissue  — 
whose  function  is  to  serve  as  a  cushion 
to  the  rectum  at  its  terminal  portion  and 
at  the  back  and  sides  of  the  wall  —  there 
is  a  triangular  space  in  front  of  the 
rectum  containing  fatty  areolar  tissue, 
which  space  is  often  the  location  of  a 
pus  cavity.  Pus,  like  all  fluids,  follows 
the  path  of  least  resistance.  The  pro- 
gress of  imprisoned  pus  may  take  weeks, 
months  and  years  before  an  abnormal 
communication  between  the  abscess  and 
the  external  portion  of  the  body  is  com- 
pleted. The  imprisoned  contents  of  the 
abscess  cavity  and  the  pus  canal  or  fistula 
often  give  rise  to  much  annoyance  before 
finding  an  outlet.  There  will  be  pain  in 
the  muscles  of  the  buttocks,  called  myal- 
gia ;  and  pain   at   the  end  of  the  spine, 

170 


Abscess  and  Fistula 

called  coccygodynia.  For  this  latter  pain 
do  not,  I  pray  you,  as  is  so  often  done, 
have  your  spine  removed  by  the  too  ready 
surgeon.  No  need  of  it  at  all.  You 
might  just  as  sensibly  have  the  muscles 
cut  out  for  myalgia.  Pus  in  fistulous 
channels  may  burrow  for  several  years 
through  the  muscular  and  connective 
tissue  structures  before  finally  forming  an 
external  opening  through  the  integument  ; 
although  its  nearness  to  the  surface  is 
frequently  marked  by  a  localized  puffiness 
and  inflammation,  which,  however,  may 
disappear  for  a  time  without  forming  an 
external  opening.  This  condition  of  af- 
fairs results  in  periodical  attacks  of 
coccygodynia,  myalgia  and  neuralgia  of 
the  buttocks  and  lower  extremities. 

The  important  question  with  the  victim 
of  abscess  and  fistula  is,  "  How  did  I  get 
it  ?  I  don't  care  for  the  various  and  nu- 
merous names  you  give  to  these  fistulas  : 
what  I  should  like  to  know  is,  How  does 
it  come  about  that  I,  an  apparently  heal- 
thy person,  have  such  a  nasty  disease  ?  " 
17X 


Intestinal  Ills 

Simply  years  of  neglect,  is  my  answer. 
Neglect  is  due  sometimes,  and  perhaps 
generally,  to  ignorance  of  the  thing  neg- 
lected. The  laity  can  in  large  measure 
blame  the  medical  profession  for  it,  and 
especially  those  surgeons  who  have  long 
made  a  specialty  of  the  treatment  of  anal 
and  rectal  diseases. 


17a 


CHAPTER  XXII. 

THE  ORIGIN  AND   USE  OF  THE  ENEMA. 

PLINY  recorded  the  fact  that  "the 
use  of  clysters  or  enemata  was  first 
taught  by  the  stork,  which  may  be  ob- 
served to  inject  water  into  its  bowels  by 
means  of  its  long  beak."  The  British 
Medical  Journal,  reviewing  the  newly 
published  Storia  della  Farmacia,  says 
that  Frederigo  Kernot  describes  in  it  the 
invention  of  the  enema  apparatus,  which 
he  looks  upon  as  an  epoch  in  pharmacy 
as  important  as  the  discovery  of  America 
in  the  history  of  human  civilization.  The 
glory  of  the  invention  of  this  instrument, 
so  beneficial  to  suffering  mankind,  belongs 
to  an  Italian,  Gatenaria,  whose  name 
ought  to  find  a  modest  place  together 
with  Columbus,  Galileo,  Gioja  and  other 
eminent  and  illustrious  Italians.  He  was 
a  compatriot  of  Columbus  and  pro- 
173 


Intestinal  Ills 

fessor  at  Pavia,  where  he  died  in  1496, 
after  having  spent  several  years  in  per- 
fecting his  instrument.  The  enema  ap- 
paratus may  be  justly  named  the  queen  of 
the  world,  as  it  has  reigned  without  a 
rival  for  three  hundred  years  over  the 
whole  continent,  besides  Brazil  and  Amer- 
ica. The  enema  came  into  use  soon  after 
the  invention  of  the  apparatus  itself. 
Bouvard,  physician  to  Louis  XIII,  ap- 
plied two  hundred  and  twenty  enemata  to 
this  monarch  in  the  course  of  six  months. 
In  the  first  years  of  Louis  XI V  it  became 
the  fashion  of  the  day.  Ladies  took 
three  or  four  a  day  to  keep  a  fresh  com- 
plexion, and  the  dandies  used  as  many  for 
a  white  skin.  Enemata  were  perfumed  with 
orange,  angelica,  bergamot  and  roses,  and 
Mr.  Kernot  exclaims  enthusiastically,  "  O 
se  tornasse  qttesta  mo  da  !  "  (Oh,  that  this 
fashion  would  return  !).  The  medical  pro- 
fession at  first  hailed  the  invention  with 
delight,  but  soon  found  the  application 
infra  dig.,  and  handed  it  over  to  the 
pharmacist ;  but  shameful  invectives,  sar< 

174 


Occasional  Cleansing 

casms  and  epigrams,  hurled  at  those  who 
exercised  the  humble  duty  of  applying  the 
apparatus,  made  them  at  last  resign  it  to 
barbers  and  hospital  attendants.  {Year 
Book  of  Therapeutics,  Wood,  1872.) 

"  The  history  of  the  warm  bath,"  says 
Dr.  Paris,  "  presents  another  curious  in- 
stance of  the  vicissitudes  to  which  the 
reputation  of  our  valuable  resources  is  so 
universally  exposed.  That  which  for  so 
many  ages  was  esteemed  the  greatest 
luxury  in  health,  and  the  most  efficacious 
remedy  in  disease,  fell  into  total  disrepute 
in  the  reign  of  Augustus,  for  no  other 
reason  than  because  Antonius  Musa  had 
cured  the  Emperor  of  a  dangerous  mal- 
ady by  the  use  of  the  cold  bath.  The 
most  frigid  water  that  could  be  procured 
was  in  consequence  recommended  on  ev- 
ery occasion.  .  .  .  This  practice,  how- 
ever, was  doomed  but  to  an  ephemeral 
popularity,  for,  although  it  restored  the 
Emperor  to  health,  it  shortly  afterward 
killed  his  nephew  and  son-in-law  Mar- 
cellus,  an  event  which  at  once  deprived 
the  remedy  of  its  credit  and  the  physician 
of  his  popularity. 
175 


Intestinal  Ills 

"  That  the  warm  and  not  the  cold  bath 
was  esteemed  by  the  ancient  Greeks  for 
its  invigorating  properties  may  be  inferred 
from  a  dialogue  of  Aristophanes,  in  which 
one  of  the  characters  says,  '  I  think  none 
of  the  sons  of  the  gods  ever  exceeded 
Hercules  in  bodily  and  mental  force.' 
Upon  which  the  other  asks,  '  Where 
didst  thou  ever  see  a  cold  bath  dedi- 
cated to  Hercules  ?' 

"  Thus  there  exists  a  fashion  in  medicine, 
as  in  the  other  affairs  of  life,  regulated  by 
the  caprice  and  supported  by  the  author- 
ity of  a  few  leading  practitioners,  which 
has  been  frequently  the  occasion  of  dis- 
missing from  practice  valuable  medicines 
and  of  substituting  others  less  certain  in 
their  effects  and  more  questionable  in 
their  nature.  As  years  and  fashion  re- 
volve, so  have  these  neglected  remedies, 
each  in  its  turn,  risen  again  into  favor 
and  notice,  whilst  old  receipts,  like  old 
almanacs,  are  abandoned  until  the  period 
may  arrive  that  will  once  more  adjust 
them  to  the  spirit  and  fashion  of  the 
times."  (J.  A.  Paris,  Pharmacologics,  p. 
31,  New  York,  1825.) 

"  A  story  told  of  Voltaire,"  says  Dr. 
Arthur  Leared,  "  well  illustrates  both  the 

176 


Occasional  Cleansing 

evil  effects  of  constipation  and  the  ad- 
vantage of  using  the  enema.  The  great 
philosopher  was  one  day  so  miserable  and 
dejected  that  he  told  a  friend  he  had  re- 
solved to  hang  himself.  His  friend  called 
the  next  morning  to  ascertain  whether 
the  resolve  had  been  or  was  intended  to 
be  carried  out.  But  Voltaire  only  re- 
plied, with  a  smile,  '  I  have  been  well 
washed  out  this  morning.'"  (Op.  cit,  p. 
200.) 

For  those  sufferings  from  chronic  intes- 
tinal  uncleanliness  or  constipation,  an  oc- 
casional intestinal  wash-out,  or  bath,  is 
quite  as  satisfactory  as  an  "  occasional " 
external  bath  or  the  "  occasional  "  use  of 
a  cathartic  medicine.  If  there  is  a  neces- 
sity for  cleansing  and  purifying  the  bow- 
els at  all,  why  not  do  it  properly  and 
systematically  until  the  condition  that 
made  the  artificial  cleansing  necessary  is 
removed  ?  Who  would  tolerate  the  clean- 
ing of  dining-room,  kitchen,  dairy  and 
other  utensils  in  domestic  use  only  when 
they  became  so  foul  that  they  could  not 
be    endured    any    longer    without    great 

177—18 


Intestinal  Ills 

annoyance  ?  Away  with  the  "  occasional  " 
cleansing  habit  for  either  external  or  in- 
ternal bodily  cleanliness  !  There  are  per- 
sistent causes  for  internal  uncleanliness, 
for  the  tardy  action  of  the  bowels,  which 
require  regular  periods  for  cleansing  until 
cure  is  effected. 

It  is  estimated  that  food  taken  into  the 
stomach  will  reach  the  colon  in  fi\e  hours. 
For  nineteen  hours  the  sewage  waste  of 
the  body  is  gradually  becoming  a  fetid 
pool  before  an  outlet  is  furnished  it  by 
the  one-movement-a-day  people  ;  and  O 
ye  gods  of  health  !  how  many  of  us  there 
are  that  have  n't  even  one  movement  a 
day  !  For  a  few  hours  the  absorbent 
cells  of  the  colon  will  try  to  extract  as 
much  of  the  nutritious  residue  as  the  sys- 
tem calls  for,  but  along  with  it  a  lot  of 
poisonous  filth  will  be  absorbed.  The 
call  of  the  system  for  nourishment  should 
be  fully  answered  by  the  small  intestines. 
Savages  have  four  or  five  movements  a 
day,   and  we   certainly   should    not    have 

less  than  three.      People  of  refined  senti- 

178 


Occasional  Cleansing 

ments  will,   at  such    a   disclosure,   bestir 
themselves  to  better  things. 

Water,  when  properly  applied,  is  the 
only  remedy  that  meets  the  physiological 
and  pathological  requirements  of  the 
chronically  constipated.  By  its  use  the 
diseased,  spasmodically  contracted  muscu- 
lar tube  is  simply  dilated,  and  the  impris- 
oned feces  and  gases  above  are  permitted 
to  pass  down  and  through  the  temporarily 
occluded  section  of  the  diseased  bowels, 
the  patient  will  have  the  consciousness  of 
neatly  accomplishing  an  imperative  re- 
quirement, and  the  satisfaction  which 
cleanliness  entails. 


179 


CHAPTER    XXIII. 

HOW  OFTEN  SHOULD  AN  ENEMA  BE  TAKEN? 

THE  following  lines  will  show  you  how 
advertising  is  done  in  medical  jour- 
nals. "  Dear  Doctor  :  The  spring  being 
the  time  for  cathartics,  I  beg  to  call  your 
attention  to  R.L.  (yellow  label),  .  .  . 

Why  is  spring  a  special  time  for  cathar- 
tics ?  Has  the  intestinal  canal  been  ob- 
structed like  the  Erie  Canal  during  the 
winter  months  ?  With  as  much  propriety 
they  might  advertise  :  "  Dear  Doctor  : 
The  spring  being  the  time  for  bathing,  I 
beg  to  call  your  attention  to  antiseptic 
bath   soap,  ..." 

I  suppose  that  a  sort  of  annual  cleansing 
of  the  alimentary  canal  is  suggested  so 
that  the  summer  heat  may  be  less  objec- 
tionable, as  it  warms  up  foul  bodies.  How- 
ever, attention  once  a  year  is  better  than 
none  at  all,  as  said  of  the  Augean  stables. 

i  So 


Enema  Not  Harmful 

Not  long  ago  I  had  a  conversation  with 
the  proprietor  of  a  bath  cabinet  company, 
who  had  given  some  thought  to  hygienic 
measures,  and  he  considered  it  essential 
to  flush  the  bowels  with  water  once  a 
month  to  secure  "  proper  cleanliness." 
This  opinion  is  quite  in  advance  of  the 
annual  cathartic  cleansing.  Some  people 
may  have  acquired  the  habit  of  a  monthly 
cathartic  "  cleansing "  ;  others  wash  out 
once  a  week,  and  a  few  once  a  day  :  all  of 
them  act  from  their  idea  of  cleanliness,  as 
they  would  perform  the  ablution  of  their 
hands,  face  and  body.  There  are  some  hy- 
gienic students  who  have  adopted  the  idea 
of  "  cleansing  "  the  bowels  with  warm  water 
once  or  twice  a  week,  which  practice  is 
quite  in  advance  of  the  annual  or  monthly 
attention.  All  have  reasons  for  the  man- 
ner and  time  they  adopt  to  "  cleanse  "  the 
bowels  ;  and  yet  they  find  that  they  are 
not  cleansed  properly,  as  they  still  have 
spells  of  biliousness  and  misery.  They 
wonder  at  themselves  for  being  so  rash 

and  bold  as  to  take  an  enema  twice  a 
m 


Intestinal  Ills 

week,  and  begin  to  feel  that  they  have 
reached  a  point  of  positive  danger. 

One  anxiety  is  that  they  will  weaken 
the  bowels  by  the  use  of  a  pint  or  a  quart 
of  water  once  a  month,  or  once  or  twice  a 
week.  Another  is  that  they  will  wash 
away  the  mucus,  leaving  the  membrane  of 
the  bowels  as  dry  as  an  oven.  Another 
is  that  they  will  form  the  dreadful  habit 
of  using  the  enemata.  What  a  pity  to 
form  such  a  cleanly  habit  !  Sorry  for 
them  ! 

Another  stubborn  objection  is,  that 
flushing  of  the  bowels  is  not  natural. 
These  foolish  objections  and  fears  can  be 
attributed  to  medical  authors  who  belong 
to  medical  societies.  It  is  very  strange 
how  these  authors  adopt  so  many  wrong 
notions  about  the  physiology  and  pathol- 
ogy of  the  bowels.  What  an  erroneous 
and  absurd  idea  that  the  enema  should 
weaken  the  bowels  !  Why  should  it  ? 
Exercise  ought  to  strengthen  muscular 
tissue  ;   and  what  could  give  the   bowels 

more  gentle  muscular  exercise  than  the 

182 


Enema  Not  Harmful 

proper  use  of  them  ?  Has  the  reader 
any  idea  of  the  amount  of  water  requisite 
for  the  distention  of  an  elastic  muscular 
tube,  about  five  feet  in  length  and  two 
and  a  half  inches  in  diameter  in  the  widest 
part  ?  The  large  intestine  is  capable  of 
great  distention,  as  is  frequently  demon- 
strated in  fecal  impaction  described  in 
previous  chapters.  The  quantity  is  named 
in  gallons.  The  amount  of  water  usually 
injected  at  one  time  —  from  one  pint  to 
two  quarts — can  hardly  be  said  to  distend 
the  bowels  at  all.  I  wish  the  enemata 
did  have  power  to  weaken  that  part  of 
the  bowel  involved  in  disease.  I  am  very 
sorry  it  does  not  weaken  it.  For  twenty 
years  it  has  been  demonstrated  to  my 
mind  that  almost  every  case  of  chronic 
constipation,  biliousness,  intestinal  foul- 
ness, diarrhea,  indigestion,  self-poisoning 
(auto-infection  or  auto-intoxication)  was 
due  to  too  much  activity  and  vigor  of  the 
lower  bowels,  this  excessive  activity  and 
vigor  being  the  result  of  chronic  proctitis, 
colitis,  etc.  To  lessen  this  muscular  irri- 
183 


Intestinal  Ills 

tability,  and  to  devise  means  to  relieve 
and  cure  quickly,  has  cost  me  more  studi- 
ous hours  than  the  a£ore<rate  of  all  the 
other  diseases  and  symptoms  of  the  lower 
bowels. 

If  liquids  washed  away  the  mucus  from 
the  mucous  membrane,  the  throats  of 
many  individuals  ought  to  be  very  harsh 
and  dry,  inasmuch  as  six  to  eight  glasses 
of  liquids  pass  through  their  mouths  and 
throats  during  every  day  of  twenty-four 
hours.  Even  after  the  "  dry  feeling  in 
the  throat  and  stomach  "  has  been  bounti- 
fully attended  to  by  the  owner,  the  con- 
versation usually  becomes  more  loquacious 
and  hilarious,  and  there  is  no  suggestion 
that  the  intemperate  person  had  spent 
many  hours  in  a  hot  desert  without  water. 
The  frequent  flushings  they  give  their 
throats  and  stomachs  really  do  not  seem 
to  wash  the  mucus  away. 

When  a  person  consults  an  oculist  about 

an   affection  of  the  eyes  and  glasses  are 

prescribed,    good   sense  will   inform  him 

that  the  glasses  must  be  worn  while  the 

184 


Enema  Not  Harmful 

imperfect  functioning  of  the  eyes  requires 
them.  If  a  limb  be  fractured  and  splints 
be  applied,  would  you  worry  lest  you  form 
the  habit  of  wearing  them  ?  Certainly 
not  ;  you  expect  in  due  time  to  recover 
the  proper  use  of  the  limb.  So  if  you  are 
compelled  to  use  crutches  you  do  not 
worry  about  forming  the  crutch  habit,  for 
you  will  use  them  as  long  as  needed  and 
discard  them  at  the  proper  time. 

As  to  its  being  unnatural  to  flush  the 
bowels  with  water,  I  would  say  that  it  is 
very  unnatural  to  suffer  from  proctitis  ac- 
companied with  its  annoying  symptoms, 
such  as  constipation,  indigestion,  diarrhea, 
auto-intoxication,  emaciation,  anemia, 
muddy  complexion,  foul  breath,  blotches 
and  pimples  on  the  face,  each  and  all  of 
which  indicate  a  physical  debasement. 

It  is  unnatural  to  wear  glasses,  crutches, 
splints,  wigs,  artificial  teeth,  artificial 
eyes,  but  many  people  do  such  unnatural 
things.  Many  of  our  habits  are  not  ex- 
actly "  natural,"  but  they  are  rational, 
none  the  less ;  such,  for  example,  as  bath- 
185 


Intestinal  Ills 

ing  the  body  night  and  morning ;  cleans- 
ing the  mouth  and  teeth  after  each  meal  ; 
and  the  nostrils  and  ears  several  times  a 
day.  The  frequency  of  these  practices 
may,  with  some  people,  be  unnecessary 
and  useless,  but  no  real  harm  is  done  by 
their  scrupulous  cleanliness — physical  and 
mental. 

Proctitis  is  usually  worse  than  it  seems 
to  be.  This  is  because  of  the  insidious 
progress  of  the  inflammation  during  the 
fifteen,  twenty  or  more  years  before  the 
local  symptoms  at  the  anus  or  in  the  anal 
canal  are  sufficiently  annoying  to  compel 
the  sufferer  to  seek  treatment.  Such  suf- 
ferers are,  as  a  rule,  born  with  the  idea 
that  the  liver  regulates  the  whole  aliment- 
ary  canal  ;  and  if  the  sufferer  has  not  this 
hereditary  notion,  his  physician  will  soon 
impart  it  to  him  with  his  diagnosis  and 
treatment.  The  disciple  of  cathartics, 
whether  the  cathartics  be  in  the  form  of 
pills,  powders,  or  solutions,  or  contain 
belladonna  and  opium  to  overcome  the 
cramping  pain  the  dose  would  otherwise 

186 


Enema  Not  Harmful 

occasion,  has  no  legitimate  reason  to  in- 
dulge in  the  hope  of  a  cure  or  of  even 
moderate  relief  of  the  real  source  of  trouble 
— the  proctitis.  It  is  proceeding  on  the 
liver  theory,  when  the  key  is,  as  has 
been  shown  in  these  articles,  Proctitis,  in- 
flammation of  the  anus  and  rectum.  Phy- 
sicians ignorant  of  the  key  to  all  bowel 
troubles  even  prescribe  strychnine  in 
order  to  stimulate  bowels  which  have 
already  an  excessive  amount  of  stimula- 
tion due  to  the  presence  of  the  proctitis, 
which,  as  has  been  said,  over-stimulates 
the  lower  bowels  because  of  the  inflam- 
mation. 

The  chronic  character  of  proctitis  of 
many  years'  duration,  improperly  diag- 
nosed and  treated,  must  necessarily  com- 
pel a  rather  long  and  continued  use  of 
the  enema,  especially  so  if  not  accompa- 
nied by  proper  local  treatment  of  all  the 
inflamed  surface.  I  should  not  care  to 
treat  patients  suffering  from  proctitis, 
constipation,  etc.,  unless  they  used  the 
enema  twice  a  day.  The  feces  and  gases 
187 


Intestinal  Ills 

should  escape  the  bowels  at  least  twice  in 
twenty-four  hours.  Any  less  than  two 
stools  a  days  is  abnormal  and  will  result 
in  infection  and  disease.  You  may  not 
always  succeed  in  having  two  stools  when 
first  treating  the  local  disease,  but  what 
you  properly  start  out  to  accomplish  will 
be  attained  in  due  time. 

Free  evacuation  of  the  contents  of  the 
bowels  should  occur  at  least  twice  in 
twenty-four  hours.  This  can  be  accom- 
plished by  injecting  into  the  colon  from 
one  to  four  quarts  of  warm  water.  Before 
taking  the  large  injection,  relieve  the 
bowels  of  any  gas  seeking  liberation,  and 
of  course,  also,  of  whatever  feces  may 
come  readily.  Then  take  a  small  injec- 
tion, using  very  little  water :  just  enough 
to  brinp-  on  a  relief  of  as  much  feces  and 
gas  as  possible.  It  is  not  well  to  drive 
the  gas  back  and  up  into  the  colon  ;  hence 
the  precaution  to  suggest  a  further  pass- 
age with  a  small  quantity  of  water  before 
taking  the  large  injection. 

Enemata,  and  also  the  use  of  the  recur- 

i8i 


Enema  Not  Harmful 

rent  douche,  can  in  no  way  be  harmful — 
if  the  water  be  of  a  proper  temperature — 
to  a  normal  or  even  to  a  diseased  bowel  ; 
therefore  the  fear  of  habit  is  absurd  and 
should  not  receive  a  moment's  considera- 
tion. The  length  of  time  during  which 
the  enemata  and  the  douche  are  to  be 
used,  whether  months  or  years,  will  de- 
pend on  the  character  of  the  disease  that 
made  its  use  necessary. 


i8g 


CHAPTER  XXIV. 

man's  best  friend. 

TRAVEL  the  world  from  end  to  end 
You  ne'er  will  find  a  better  friend 
Than  sparkling  water,  pure  and  (reet 
Most  precious  boon  to  you  and  me. 
It  cheers  the  faint,  it  crowns  the  feast, 
Makes  food  to  grow  for  man  and  beast; 
In  sickness  soothes  the  fevered  frame, 
There  's  healing  in  its  very  name. 
And  what  can  more  life-giving  be 
Than  cooling  breezes  from  the  sea, 
Whose  bosom  bears  upon  their  way 
The  stately  ships  from  day  to  day? 
A  treasure  trove  of  priceless  worth ; 
A  jewelled  belt  for  mother  Earth, 
Encircling  with  its  silvery  bands, 
She  binds  together  many  lands. 
To  cure  disease  dame  Nature  brings 
Her  remedy  in  mineral  springs; 
Water  without,  water  within, 
Equally  good  for  stout  or  thin  ; 
And  more  than  man  can  e'er  devise 
Invigorates  and  purifies. 
Travel  the  world  from  end  to  end, 
You  ne'er  will  find  a  better  friend. 

190 


CHAPTER  XXV. 

PHYSIOLOGICAL  IRRIGATION. 

THE  scientific  irrigation  of  land  is  pretty 
well  understood  by  those  who  have 
financial  interest  in  soil  requiring  it.  The 
wonderful  beauty  and  freshness  of  flower 
and  fruit  give  evidence  of  what  scientific  ir- 
rigation can  do.  So  from  a  commercial  and 
esthetic  point  of  view  the  proper  amount 
of  daily  moisture  for  land,  tree  or  vine,  is 
of  such  importance  that  it  receives  the 
consideration  of  those  interested.  How 
many  persons,  however,  in  the  course  of  a 
lifetime  have  given  ten  minutes  to  ser- 
ious consideration  of  the  question  :  Hozv 
much  water  should  be  imbibed  daily  under 
the  varying  conditions  of  the  bodys  gar- 
den f  Those  who  give  no  consideration 
to  the  problem  of  how  to  attain  and  main« 
tain  a  healthy  and  vigorous  physical  basis 

are  persons  who  usually  drift  into  habits 

191 


Intestinal  Ills 

for  which  they  will,  sooner  or  later,  have 
to  pay  the  penalty. 

For  the  first  twenty  or  more  years  the 
body  is,  as  a  rule,  unfortunate  in  not  hav- 
ing an  intelligent  tenant.  For  man  mis- 
uses his  physiological  estate,  and  lets 
things  go  to  rack  and  ruin  ere  he  wakes 
to  realize  how  it  might  have  been  as  to 
length  of  days  and  strength  of  body  and 
mind.  Enlighten  him,  after  he  has  reached 
adult  years,  on  the  values  and  needs  of 
physiological  and  psychological  functions  ; 
you  will  find  that  however  eager  he 
may  be  to  follow  the  light  he  is  handi- 
capped by  vicious  habits  and  by  confirmed, 
destructive  changes  which  had  seized  on 
him  when  he  was  quite  too  young  and 
incompetent  to  care  for  his  body.  What 
a  topsy-turvy  world  this  is,  to  be  sure  ! 

It  is  astonishing  what  a  number  of  peo- 
ple there  are  who  drink  little  or  nothing, 
and  especially  amazing  is  it  to  find  this 
lack  of  sense  in  people  suffering  from 
constipation.      One   would   suppose    that 

they  above  all  others  would  see  the  wis- 

192 


The  Need  of  Water 

dom  of  irrigating  their  bowels.  But  it  is 
seldom  that  there  is  one  who  thinks  of 
such  a  thing.  A  cup  of  coffee  or  tea  at 
meal-time,  in  addition  to  the  liquid  con- 
tained in  the  food,  is  the  extent  of  water 
consumption  by  ever  so  many  teetotalers 
and  other  "totalers,"  especially  women, 
until  they  reach,  say,  thirty  years  of  age. 
Such  persons  as  a  rule  are  not  long-lived, 
inasmuch  as  their  power  of  resistance  is 
small,  owing  to  their  lack  of  blood,  a  lack 
in  quality  as  well  as  in  quantity.  The 
blood  pressure  in  their  arteries  and  veins 
is  light,  as  evidenced  by  their  pale,  sallow 
complexion,  and  the  dry,  scaly,  feverish 
skin,  which  seldom  or  never  perspires. 
The  body  garden  has  not  been  properly 
irrigated  and  is  slowly  drying  up  as  age 
advances.  Did  you  ever  notice  how  like 
death  such  persons  appear  when  they  are 
asleep  ?  Their  dull,  pasty  complexions 
alarm  us  then.  When  I  see  them  a  de- 
sire to  soak  these  dried  specimens  of 
humanity  possesses  me.  Is  it  not  unfor- 
tunate that  we  were  not  born  with  an 
193— r3 


Intestinal  Ills 

automatic  irrigator  ?  We  even  lack  a  tube 
on  our  boiler  to  indicate  the  danger  point ! 
Deficient  by  nature  in  these  little  conven- 
iences, and  unaided  by  science,  man  is 
compelled  to  give  some  attention  to  the 
irrigation  of  his  physiological  soil,  how- 
ever indifferent  or  careless  he  may  be. 

Planters  and  o-ardeners  have  treatises, 
on  irrigation.  Have  mothers  or  nurses 
any  similar  guides  ?  Such  books  are  un- 
known to  modern  civilization.  Infants, 
boys  and  girls,  and  adults  are  brought  up 
haphazard,  and  their  garden  of  life  be- 
comes choked  with  weeds.  The  drought 
soon  makes  itself  felt,  and  a  little  grave- 
yard mound  is  their  usual  fate.  Before 
some  of  us  wither  and  fade,  to  what  a 
pest-weed  is  our  adipose  changed  for 
want  of  life-giving  water. 

Man's  most  serious  physiological  fault 
is  the  toleration  of  constipation  ;  or  even 
of  semi-constipation  induced  by  the  twenty- 
four-hour  habit  of  stooling.  In  other 
words,  his  fault  is  the  toleration  of  intes- 
tinal   uncleanliness.    -  And    next    to    this 

194 


The  Need  of  Water 

foolhardiness  is  his  negligence  in  the  mat- 
ter of  drinking  daily  a  quantity  of  pure 
soft  water  sufficient  to  aid  in  the  proper 
stimulation  and  circulation  of  the  blood, 
in  the  proper  elimination  of  the  waste 
material  from  the  body,  and  in  the  proper 
assimilation  of  nutriment  by  the  system. 

If  parents  would  encourage  their  chil- 
dren to  become  bibbers  of  pure  spring 
water  daily  it  would  not  be  easy  to  make 
them  bibbers  of  intoxicants  in  after  years. 
I  would  give  a  child  all  the  liquid  it  de- 
sires, I  would  even  encourage  it  to  take 
more  rather  than  less,  and  the  best  liquid 
of  all  for  this  purpose  is  pure  soft  water. 
Man's  body  is  70  per  cent  water.  It  is 
therefore  a  good-sized  water  cask  with  a 
ramification  of  countless  canals  or  pipes 
imbedded  in  soft  connective  tissues, 
nerves  and  muscles,  all  of  which  are  sup- 
ported by  a  bony  framework  ;  through 
the  centre  of  this  runs  the  alimentary 
canal,  down  which  waters  may  flow  and 
disappear  like  unto  a  stream  lost  in  the 
sand,  to  reappear  and  ooze  from  skin, 
195 


Intestinal  Ills 

lungs,  kidneys  and  intestinal  canal.  Every 
organ  and  tissue  luxuriates  in  water ; 
they  lave  and  live  in  and  by  it.  With  all 
kinds  of  food  it  is  introduced  into  the 
body.  Water  acts  as  a  solvent  for  the 
nutritious  elements  and  as  a  sponsor  for 
the  elimination  of  foreign  substances  and 
worn-out  tissues  of  the  system.  It  also 
serves  to  maintain  a  proper  degree  of 
tension  in  the  tissues,  which  tension  is  es- 
sential to  the  proper  circulation  of  the 
lymphatic  fluids. 

The  tonic  reaction  of  externally  applied 
water  is  well  known.  But  the  advantages 
of  the  internal  use  of  water  are  hardly 
known  at  all  because  the  reactions  of  the 
circulation,  temperature,  respiration,  di- 
gestion and  secretions  are  less  noticed. 

Two  or  three  pints  of  cold  water  at  a 
temperature  of  forty  to  forty-five  degrees 
drunk  at  intervals  of  half  an  hour  will  re- 
duce the  pulse  from  eight  to  thirty  beats. 
The  copious  drinking  of  cold  water  will 
act   as    a    diuretic,     removing    stagnated 

secretions,    and   will    at   the   same    time 

196 


The  Need  of  Water 

improve  the  quality  of  the  pulse  and  the 
arterial  tone.  The  drinking  of  warm 
water  will  increase  the  pulse  from  five  to 
fifteen  beats,  and  at  the  same  time  will  re- 
lax the  vessel  walls  and  also  increase  the 
cutaneous  secretions  to  a  marked  degree. 

The  drinking  of  a  large  quantity  of 
water  not  only  increases  the  secretions  of 
the  kidneys  —  assisting  them  in  the  work 
of  carrying  off  solid  constituents,  espe- 
cially urea —  it  also  increases  the  secre- 
tions of  the  skin,  saliva,  bile,  etc.  Under 
proper  conditions  the  internal  use  of 
water  acts  as  a  stimulant  to  the  nerves 
that  control  the  blood-vessels,  a  stimulant 
similar  to  that  produced  by  its  external 
application. 

I    advise    the    drinking   of   a   copious 

quantity  of  water  daily.     There  need  be 

no   fear  that   this  practice   will   thin   the 

blood  too  much,  as  the  ready  elimination 

of  the  water  will  not  permit  such  a  result 

to   ensue.       I    would   further   advise   the 

generous  use  of  water  (temperature  6oc) 

at  meal-times.      I  pray  you  do  not  drink 
197 


Intestinal  Ills 

to  wash  down  food  :  a  bad  habit  of  most 
of  us.  Drink  all  you  desire  ;  and  if  you 
are  like  many  who  have  no  desire  for 
water,  cultivate  it,  even  if  it  takes  years. 
The  imbibed  water  will  be  in  the  tissues 
in  about  an  hour  ;  and  the  entire  quantity 
will  escape  in  about  three  and  one-half 
hours.  The  demand  on  the  part  of  the 
system  for  water  is  subject  to  great  varia- 
tion and  is  somewhat  regulated  by  the 
quantity  discharged  from  the  organism. 
Physiologists  declare  that  water  is  formed 
in  the  body  by  a  direct  union  of  oxygen 
and  hydrogen,  but  those  who  have  culti- 
vated the  drink-little  habit  need  not  hope 
to  find  an  excuse  for  themselves  in  this 
fact :  chronic  ill-health  betrays  them. 
Water  in  organic  relations  with  the  body 
never  exists  uncombined  with  inorganic 
salts  (especially  sodium  chloride)  in  any 
of  the  fluids,  semi-solids,  or  solids  of  the 
body.  It  enters  into  the  constitution  of 
the  tissues,  not  as  pure  water,  but  always 
in   connection   with   inorganic   salts.       In 

case  of  great  loss  of  blood  by  hemorrhage, 

198 


The  Need  of  Water 

a  saline  solution  of  six  parts  of  sodium 
chloride  with  one  thousand  parts  of  steril- 
ized water  injected  into  the  system  will 
wash  free  the  stranded  corpuscles  and  give 
the  heart  something  to  contract  upon. 

When  water  is  taken  into  the  stomach, 
its  temperature,  its  bulk,  and  its  slight  ab- 
sorption react  upon  the  system  ;  but  the 
major  part  of  it  is  thrown  into  the  intes- 
tinal canal.  When  it  is  of  the  tempera- 
ture of  about  6o°  it  gives  no  very  decided 
sensation  either  of  heat  or  cold  ;  between 
6o°  and  450  it  creates  a  cool  sensation, 
and  below  450  a  decidedly  cold  one. 
Water  at  a  temperature  of  about  500  is  a 
generator  of  appetite.  A  sufficient  quan- 
tity should  be  taken  for  that  end  ;  say, 
one  or  two  tumblers  an  hour  or  so  before 
each  meal,  followed  by  some  exercise. 
Those  who  have  acquired  the  waterless 
habit,  and  the  many  ills  resulting  from  it, 
will  hardly  relish  cool  water  as  an  appe- 
tizer ;  but  if  they  would  become  robust 
they  must  adopt  the  water  habit — a  habit 

that  will  refresh  and  rejuvenate  nature. 
199 


Intestinal  Ills 

Water  of  a  temperature  between  6o° 
and  ioo°  relaxes  the  muscles  of  the  stom- 
ach and  is  apt  to  produce  nausea,  espe- 
cially if  the  effect  of  bulk  be  added  to  that 
of  temperature.  Lukewarm  water  seems 
to  excite  an  upward  peristalsis  of  the  in- 
testines and  thus  produces  sickness. 

Hot  water  acts  as  a  stimulant  and  anti- 
septic, as  a  sedative  and  as  a  food.  Water 
at  a  temperature  of  i  io°  to  1 200,  or  more, 
will  nearly  always  relieve  a  foul  stomach 
and  intestines.  It  should  be  slowly  sipped, 
so  that  the  stomach  may  not  be  uncom- 
fortably distended.  After  imbibing  a  pint 
or  a  pint  and  a  half,  wait  for  fifteen  or 
thirty  minutes  to  give  it  time  to  pass  into 
the  bowels,  then  drink  more  if  thought 
advisable.  Drink  it  an  hour  before  meal- 
time. It  will  excite  downward  peristalsis, 
will  dilute  the  foul  contents  of  the  stom- 
ach, and  will  thus  aid  the  escape  of  these 
contents  into  the  intestines,  which  latter 
require  the  washing  process  as  well. 
Sometimes  it  is  a  good  thing  to  omit  one, 
two  or  three  meals  while  the  washing  pro- 


The  Need  of  Water 

cess  is  beinof  continued.  Commence  treat- 
ment  with  pure  hot  water.  To  make  it 
appetizing,  add  a  pinch  of  salt  or  of  bicar- 
bonate of  soda ;  with  children  add  sugar. 
It  will  pay  you  to  follow  this  treatment 
for  the  cleansing  of  the  alimentary  canal 

The  vitality  of  the  body  may  be  sus- 
tained for  days  and  weeks  on  water  alone  ; 
there  is  therefore  no  hurry  about  food. 
If  human  beings  would  only  keep  their 
bowels  and  stomachs  clean  they  would 
avoid  all  the  ills  that  flesh  is  heir  to,  ex- 
cept, of  course,  those  due  to  accident. 

My  remarks  have  been  confined  to  irri- 
gation per  or  em  (that  is,  by  way  of  the 
mouth),  and  nothing  has  been  said  of  irri- 
gation per  anum  (by  injection),  since  I 
have  treated  the  latter  subject  fully  in 
several  previous  chapters,  to  which  the 
reader  is  referred.  Be  sure  to  follow  the 
counsel  there  given,  and  use  the  enema 
two  or  three  times  a  day  in  moderate 
quantities  as  indicated. 


90t 


CHAPTER   XXVI. 

PROPER   TREATMENT   FOR   DISEASES   OF  THE 
ANUS   AND    RECTUM    VERY    ESSENTIAL. 

NO  doubt  the  readers  of  the  preceding 
chapters  on  proctitis  and  its  numer- 
ous symptoms  —  noted  under  separate 
headings — would  like  to  know  something 
about  the  home  treatment  for  such  an  in- 
sidious and  grave  disease.  Every  sufferer 
wants  to  be  a  self-doctor.  This  commend- 
able desire  it  is  usually  impossible  to  put  in- 
to practice.  If  physicians  so  often  fail  to 
cure  the  ailments  I  have  described,  what  can 
be  expected  of  those  who  have  no  know- 
ledge at  all  of  diagnosis  and  treatment  ? 

A  skilful  physician  is  the  choicest  gem 
of  civilization,  and  an  intelligent  patient 
its  worthy  setting.  Surely  it  is  a  moral 
crime,  an  inexcusable  folly  to  tolerate  a 
disease  with  its  inevitable  train  of  dire 
consequences,  up  to  the  point  when  the 


Proper  Treatment  Essential 

discomfort  compels  one  to  seek  treat- 
ment. There  are  patients,  of  course, 
who  have  good  and  sufficient  excuses  for 
their  painful  predicament ;  they  have,  for 
example,  tried  persistently  for  relief  and 
cure,  but  have  failed  to  find  a  physician 
competent  to  treat  their  particular  case. 
How  many  unskilled  prescribers  there 
are,  and  how  glaring  their  shortcomings  ! 
Some  hold  out  taking  inducements  to  suf- 
ferers ;  their  one  object  being  to  transfer 
their  patients'  cash  to  their  own  pocket. 
'T  were  charitable  to  consider  these  ig- 
norant ;  but  alas  !  many  of  them  are  poi- 
soned by  the  "  fakir"  germ.  Stuff  is  sold 
by  the  conscienceless,  claiming  to  cure 
"piles,"  to  "give  instant  relief,"  and 
promising  "  a  complete  cure  in  a  few 
days " ;  and  as  to  itching  piles,  why ! 
"  only  a  few  applications  are  necessary  for 
a  cure  ;  six  boxes  for  five  dollars  "  !  etc. 

No  remedy  that  sufferers  apply  them- 
selves can  be  more  than  a  temporary  re- 
lief :  it  cannot  really  cure  piles,  polypus, 

fistula,   tabs,   pruritus    (itching)  —  all    of 
203 


Intestinal  Ills 

them  consequences  of  proctitis.  Of 
course  one  should  be  thankful  for  the  lit- 
tle relief  to  be  got  temporarily  from  ad- 
vertised and  drugstore  drusis  •  nothing: 
more  than  relief  can  be  expected  of  them. 
There  are  indeed  times  when  a  palliative 
treatment  will  serve  to  tide  the  sufferer 
over  a  few  days  until  he  is  able  to  con- 
sult a  competent  physician.  But  how 
strange  it  is  that  so  many  sufferers  regard 
their  anatomy  and  physiology  so  lightly 
as  to  think  of  using  remedies,  even  for 
relief,  without  first  undero-oingr  a  thorough 
examination  by  a  competent  physician. 
In  troubles  of  a  rectal  character  it  is  ex- 
ceedingly foolhardy  to  allow  any  one  to 
prescribe  without  insisting  upon  a  thor- 
ough examination  to  ascertain  whether 
there  be  any  disease  of  a  cancerous  nature 
present,  or  what  the  trouble  actually  is, 
and  its  progress.  To  expect  one  remedy 
or  prescription  to  meet  all  the  require- 
ments for  the  cure  of  a  chronic  disease  of 
the   anus  and  rectum    and  of   the   many 

complications  accompanying  it  is  hardly 

204 


Proper  Treatment  Essential 

sensible,  but  that  is  just  what  a  great 
many  do  expect.  No  one  remedy  in  the 
market,  or  any  number  of  them  combined, 
can  effect  a  cure,  for  the  simple  reason 
that  proper  local  treatment  by  a  physi- 
cian is  of  paramount  importance.  Un- 
less of  a  traumatic  (externally  produced 
wound)  origin,  diseases  of  the  anal  and 
rectal  canals  are  usually  of  fifteen,  twenty 
or  more  years'  incubation  before  the  an- 
noying symptoms  become  apparent.  This 
accounts  for  the  slight  attention  to  the 
maturing  trouble  and  for  the  fact  that 
such  attention  can  afford  nothing  more 
than  a  palliation  or  postponement.  A 
real  cure  requires  a  combination  of  means, 
all  working  harmoniously  for  the  proper 
length  of  time.  Proper  treatment  and 
the  proper  time  are  the  two  prime  requi- 
sites ;  and  the  third  and  final  requisite  is, 
of  course,  a  sensible  patient. 

Before  home  treatment  is  to  be  thought 
of  it  is  accordingly  advisable  to  have  an 
examination   and  a  prescription   for  the 

specific  local   treatment   necessary  for  a 
205 


Intestinal  Ills 

trouble  like  piles,  fissure,  polypus,  tabs, 
itching,  fistula,  varicose  veins,  abscess, 
ulcer,  granulation,  hypertrophy,  or  atrophy- 
as  the  case  may  be.  The  local  treat- 
ment can  best  be  aided  by  a  combination 
of  remedies  with  suitable  instruments  for 
their  use  between  the  periods  of  local  at- 
tention by  the  physician.  The  writer  of 
this  has  no  cure-all  to  send  the  sufferers, 
although  it  might  be  to  his  financial  ad- 
vantage to  have  one  ;  he  is,  however,  al- 
ways ready  to  advise  and  relieve  those 
who  cannot  visit  him  immediately.  The 
relief  afforded  often  facilitates  the  cure  by 
permitting  a  more  extensive  local  treat- 
ment at  the  first  visit. 

The   Use  of  Instruments  for  Injecting 
Water. 

To  do  something  at  home  for  one's  self 
for  relief  from  soreness  and  pain  due  to 
anal  and  rectal  diseases,  a  few  suitable  in- 
struments are  required  with  which  specific 
remedies  may  be  used,  especially  that  ex- 
cellent remedy — water. 

206 


Proper  Treatment  Essential 

It  is  unfortunate  that  the  anal  and  rec- 
tal canals  cannot  be  given  rest  when  in- 
vaded by  disease.  Daily  elimination  of 
feces  is  a  very  important  factor  to  health 
and  to  treatment.  To  accomplish  this  the 
very  best  means  is  water  in  various  quan- 
tities as  the  case  demands.  It  does  not 
irritate  the  diseased  canals — as  cathartics 
do — but  aids  in  the  escape  of  imprisoned 
feces  and  gases  which  lodge  above  the 
region  of  the  morbid  process.  Evacuation 
should  be  accomplished  twice  a  day,  by  the 
injection  at  first  of  three  or  four  quarts  of 
water  —  thus  obtaining  a  good  daily  flush- 
ing of  one's  sewer  —  and  then,  if  advisable, 
gradually  lessening  the  quantity  at  subse- 
quent injections  to  one  or  two  pints  at  a 
time.  The  temperature  should  be  ioo°  to 
1050  or  more.  Some  people  have  an  idea 
that  water  at  the  temperature  named  has 
a  remedial  effect  on  an  inflamed  anus  and 
rectum.  It  has  none  whatever  ;  all  it  does 
is  to  wash  away  the  deposits  which  might 
irritate   the  inflamed  surface.     Water  at 

a  temperature  of  ioo°  to   1050  is  not  an 
207 


Intestinal  Ills 

especially  good  antiseptic;  and  its  intestinal 
use  should  not  be  continued  longer  than 
to  bring  away  the  effete  and  fetid  material 
which  may  be  lodged  in  the  colon,  sig- 
moid flexure  and  rectum.  In  the  majority 
of  cases  its  use  should  be  limited  to  aid- 
ing the  feces  to  escape  from  their  normal 
receptacle  —  the  sigmoid  flexure  —  when- 
ever proctitis  does  not  extend  beyond  the 
rectum.  But  many  persons  are  deceived 
by  the  conduct  of  proctitis  and  are  thus 
likely  to  omit  the  regular  irrigation  twice 
a  day.  They  believe  themselves  to  be  in 
pretty  good  condition  and  do  not  realize 
that  their  old,  implacable  enemy  may  be 
excited  into  riot  any  day ;  in  which  case 
the  insurrection  may  last  for  months  and 
then  slowly  settle  down  to  semi-quiet 
again,  reaching  finally  the  point  of  its 
best  behavior  for  a  short  period  or  until 
again  provoked. 

The  Use  of  the  Recurrent  Douche. 

Water  at  a  temperature  of  1200  to  1300 

properly  applied   is   a   good   therapeutic 

208 


Proper  Treatment  Essential 

agent  in  the  treatment  of  proctitis.  At 
that  temperature  it  is  an  excellent  anti- 
septic and  astringent.  Its  continuous  use 
for  half  to  one  hour  applied  with  a  recur- 
rent douche  brings  about  a  contraction  of 
the  engorged  and  dilated  blood-vessels  ; 
and  accompanied  by  local  treatment  and 
by  other  remedies  is  the  best  means 
known  for  restoring  the  nerves  to  their 
normal  function  of  controlling  the  proper 
circulation  of  blood  in  the  diseased  organ. 
Treatment  with  the  recurrent  douche  is 
of  course  to  follow,  not  to  precede,  the 
evacuation  of  the  bowels  ;  but  at  any  time 
when  there  is  a  tendency  toward  addi- 
tional evacuation  on  the  admission  of  the 
hot  water,  the  new  douche  is  easily  adjust- 
able to  the  contingency  without  removal 
from  the  anal  canal ;  it  will  facilitate 
the  escape  of  the  feces  with  the  return 
flow  of  the  water.  The  new  recurrent 
douche  has  therefore  the  great  advantage 
of  promoting  simultaneously  both  the 
thorough   evacuation   of   the  bowels  and 

the  therapeutic  effect  of  hot  water. 
209 — *4 


Intestinal  Ills 
Sitz-Bath. 

There  are  patients  who,  because  of  years 
of  neglect  of  their  local  ailments,  are  taken 
with  severe  attacks  of  inflammation  of  the 
anus  and  rectum,  involving  considerable 
prolapse,  much  swelling  around  the  anus, 
and  general  local  soreness  and  pain  ;  all  of 
which  is  often  accompanied  by  a  general 
disrelish  of  life.  For  this  condition  noth- 
ing is  so  good  as  a  very  hot  sitz-bath,  if 
properly  adjusted  to  the  parts  and  con- 
tinued for  about  an  hour  at  a  sitting. 
The  alleviation  afforded  is  so  decided  and 
the  local  and  prolonged  application  of  hot 
water  so  restorative  that  it  may  be  left  to 
the  sufferer  to  determine  how  often  this 
bath  is  to  be  repeated.  It  may  be  taken 
as  often  as  there  is  an  inclination  to  do  so. 
The  sitz-bath  apparatus  should  be  scien- 
tifically adapted  to  the  parts  so  that  the 
bather  will  not  sit  lower  than  ten  or 
twelve  inches,  thereby  avoiding  a  strain- 
ing position.  During  the  bath  there 
should  be  more  or  less  pressure  against 


Proper  Treatment  Essential 

the  anal  tissues,  which  assists  the  hot 
water  in  expelling  the  blood  from  the 
inflamed  parts.  From  the  beginning  to 
the  end  of  the  bath  the  water  must  be 
as  hot  as  the  tissues  will  tolerate.  Only  a 
small  portion  of  the  buttocks  need  be  im- 
mersed in  the  hot  water. 

Spring  Water  the  Ideal  Beverage. 

Those  who  suffer  from  disease  of  the 
rectum,  with  rare  exceptions,  are  consti- 
pated or  semi-constipated,  which  condition 
in  turn  aggravates'  or  disturbs  the  inflamed 
parts.  To  overcome  this  constipated  con- 
dition all  sorts  of  laxatives  are  taken, 
which  will  in  the  end  do  grave  harm  not 
only  to  the  whole  system,  but  especially 
to  the  inflamed  parts,  irritating  them  still 
more.  There  is  a  valuable  therapeutic 
agent  seldom  taken  by  the  constipated  ; 
in  fact,  it  is  never  thought  of;  unfortu- 
nately the  remedy  is  not  easily  to  be  had 
in  its  pure  state  by  most  of  us,  boxed  as 
we  are  in  cities.  Sold  under  various 
names  as  mineral  water,  it  is  too  often 


Intestinal  Ills 

adulterated.  'T  is  a  simple  remedy,  and 
yet  it  has  a  wider  range  of  healing  power 
than  any  other ;  a  universal  solvent,  ap- 
plicable to  all  diseases  and  all  states  of 
health.  I  would  write  it  at  the  head  of 
all  remedial  agents :  pure  spring  water ! 
We  do  not  drink  enough  water.  If  we 
were  to  imbibe  at  least  two  quarts  of  pure 
water  daily  we  would  be  healthier  and 
have  better  movements  of  our  bowels. 
Water  may  be  taken  freely  during  meal- 
time ;  not,  however,  for  the  purpose  of 
washing  down  half-masticated  food.  Al- 
coholic drinks,  coffee  and  tea  would  better 
be  dispensed  with,  also  tobacco.  The 
nervous  system  has  enough  to  bear  with- 
out the  use  of  avoidable  irritants. 

Other  Hygienic  Agencies. 

Too  much  cannot  be  urged  as  to  the 
advisability  of  a  proper  amount  of  exer- 
cise, sleep,  rest,  food,  breathing,  cleanli- 
ness (internal  and  external),  as  well 
as  and  above  all,  pure,  high-minded 
thoughts    and  serene  temper — the    out- 

212 


Proper  Treatment  Essential 

come  of  the  habit  of  viewing  life  philo- 
sophically. Care  should  be  taken  to 
protect  the  feet  and  body  from  sudden 
climatic  changes,  thus  avoiding  catarrhal 
troubles,  especially  of  the  lower  bowels. 
As  to  the  wise  and  proper  use  of 
nature's  pharmacopoeia,  nothing  need  be 
said  here.  However,  I  may  be  within 
my  limits  when  I  advise  patients  to  use  a 
little  sense  and  not  neglect  disease  of  the 
lower  bowel  any  more  than  they  would 
neglect  that  of  the  eye,  ear  and  throat. 
In  the  latter  case  they  submit  at  once  to 
an  examination.  Why  not  in  the  former? 
Let  them  bear  in  mind  that  the  cure  of 
chronic  proctitis  is  no  holiday  job  ;  that  it 
is,  on  the  contrary,  a  task  which  re- 
quires constant  attention.  To  merely 
relieve  the  annoying  symptoms  that  ac- 
company it  cannot  be  called  a  cure.  But 
on  the  other  hand  relief  may  be  the  com- 
mencement of  a  cure.  Of  course  the 
true  way  of  looking  at  the  subject  of  this 
disease  is  to  regard  the  cure  of  proctitis  as 

necessarily  leading  to   the  disappearance 
313 


Intestinal  Ills 

in  time  of  all  the  other  troubles  that  were 
the  outcome  of  that  ailment.  Through 
the  harmonious  efforts  of  patient  and 
physician,  marvellous  results  are  often 
obtainable. 


314 


CHAPTER    XXVII. 

THE   BODY'S   BOOK-KEEPING. 

MAN'S  food  is  as  varied  as  his  work, 
more  varied  than  the  climate,  with 
one  food  for  the  luxurious  and  one  for 
the  poor.  The  majority  of  us  take  what 
we  can  get,  making-  no  complaints ;  even 
when  we  have  a  cook  and  a  good  one  the 
same  is  true.  The  ideal  diet  prepared  by 
the  ideal  cook  no  one  has  as  yet  made 
fashionable,  but  one  thing  is  within  the 
reach  of  all  ■ — -  cleanliness  of  the  sewers  of 
the  body.  Keep  the  contents  of  the 
bowels  moving  down  and  out  steadily  and 
regularly  and  you  may  eat  almost  any 
food  and  in  almost  any  preparation  and 
still  be  healthy. 

Just  as  a  steam-engine,  running  at  a 
given  rate  of  speed,  must  be  supplied 
with  fuel  sufficient  to  maintain  that  speed, 

so  the  human  body  must  have  the  requi- 
215 


Intestinal  Ills 

site  food  to  maintain  the  speed  of  civilized 
society  and  business,  and  replace  the 
waste  of  the  tissues  ;  otherwise  decline 
sets  in  and  the  reserve  store  of  strength 
is  exhausted.  How  shall  we  determine 
the  proper  amount  and  kind  of  food  for  the 
various  a^es,  sexes,  and  conditions  of  life  ? 
A  leading  authority  says  that  the  char- 
acter and  amount  of  the  daily  excreta 
furnish  suggestions  as  to  the  required 
food  supply.  (Kirk's  Physiology,  p.  208.) 
These  excreta  are  found  to  be  carbon, 
nitrogen,  hydrogen,  oxygen  in  great  part, 
with  some  sulphur,  phosphorus,  chlorine, 
sodium,  etc.  A  summary  is  given  (ibid., 
p.  432)  of  the  expenditure  for  twenty-four 
hours  : 

1.  From  the  lungs  : 

Carbonic  acid about  15,000  grains 

Water "       5,000 

2.  From  the  skin  : 

Water M     11,500      " 

Solid  and  gaseous  matters "  250      " 

3.  From  the  kidneys  : 

Water "     23,000      " 

Organic  matter "  680      " 

Saline  bodies "  420      " 

216 


Gain  and  Loss 

4.  From  the  intestines  : 

Water about  2,000  grains 

Organic  and  mineral  substances....     "  800     " 

Total  daily  expenditure  : 

Solid  matters "     17,150      *' 

Water "     49,500      " 

Altogether  about  eight  and  a  half  pounds. 
The  credit  side  of  the  sheet  is  about  as  follows  : 

Solids  (chemically  dry  foods) 8,000  grains 

Water,  combined  or  otherwise 35,000  to  40,000      " 

Oxygen,  absorbed  by  the  lungs 13,000      " 

Altogether  about  eight  and  a  half  pounds. 

With  the  proper  balance  between  the 
intake  and  the  outgo,  the  functions  of 
the  body  will  be  carried  on  normally,  but 
the  balance  must  be  a  proper  one  ;  that  is, 
not  only  must  the  entire  waste  be  re- 
paired but  the  correct  proportions  of  one 
kind  of  food  and  another  must  be  ob- 
served. If  all  the  elements  needed  are 
not  furnished  there  can  be  no  true  coun- 
terpoise. 

How  do  we  expend  the  energy  ?  By 
the  common  wear-and-tear  incident  upon 
all  voluntary  motion,  all  work  and  recrea- 
tion, carrying  on  the  internal  movements 
of  digestion  and  respiration,  by  thinking, 

by  loss  of  temperature,  by  indulgence  of 
217 


Intestinal  Ills 

any  of  our  functions,  and  by  any  wrong 
indulgence  especially.  Excessive  use, 
voluntary  or  otherwise,  will  of  course  di- 
minish our  total  capital  and  cut  short  our 
lives.  Could  we  always  maintain  the 
right  balance  we  need  never  die. 

The  importance  of  what  has  been  said 
must  now  be  clearly  apparent.  We  ought 
to  be  wisely  interested  in  choosing  the 
proper  foods  for  our  daily  needs  and  in 
having  them  properly  prepared  ;  we  ought 
to  know  how  much  carbohydrates  we  need, 
how  much  proteids,  and  regulate  our 
diet  accordingly.  The  foods  which  con- 
tain nitrogen  are  chiefly  the  following  : 
flesh  of  all  animals,  milk,  eggs,  leguminous 
fruits  (peas,  beans,  lentils)  ;  those  which 
contain  carbohydrates  chiefly  are  bread, 
starch,  vegetables  and  especially  potatoes, 
rice,  etc.  ;  foods  supplying  fat  are  butter, 
lard,  fat  of  meat,  etc.  Salts  are  furnished 
in  almost  all  other  substances,  but  espe- 
cially in  green  vegetables  and  fruits. 
Liquid  food  is  obtained  by  water,  too  often 

neglected,  and  tea,  coffee,  beer,  cider,  etc. 

218 


Gain  and  Loss 

Alcohol  has  no  power  to  form  tissue  or 
to  repair  waste  and  cannot  be  regarded  as 
a  true  food.  Tea  and  coffee  are  almost 
entirely  stimulant,  not  nutritious,  and 
should  be  taken  sparingly  or  not  at  all. 

The  common  mistakes  in  diet  are  over- 
feeding or  taking  too  much  of  one  kind 
of  food,  and  of  the  latter  class  perhaps  an 
excess  of  starchy  food  is  the  most  mis- 
chievous. If  taken  in  excess,  especially 
by  the  young,  the  starchy  foods. are  not 
digested  and  what  does  not  digest  must 
putrefy  :  the  result  is  a  bowel  distended 
with  harmful  gases.  Many  people  eat 
too  much  nitrogenous  food,  with  resulting 
plethora  or  gout.  A  great  deal  of  vigor- 
ous exercise  in  the  open  air  is  required  to 
use  up  such  a  diet. 


219 


CHAPTER   XXVIII. 

SELECTION   AND   PREPARATION   OF   FOOD. 

THE  requirements  for  normal  di- 
gestion, assimilation  and  elimination 
are  :  (i)  An  intestinal  canal  clean  and 
sound  from  mouth  to  anus  ;  (2)  nutritious 
food  properly  prepared ;  (3)  regularity 
and  moderation  in  eating  ;  (4)  free  use  of 
pure  water,  sufficient  to  forward  the 
emulsification  and  assimilation  of  the  food 
and  the  elimination  of  waste — whether 
that  waste  be  of  the  residual  portion  of 
the  food  or  of  detritus  of  tissue  ;  (5)  a 
seasonably  clad  body,  free  from  fatigue 
or  loss  of  sleep  ;  (6)  a  cheerful  mind. 

Every  sensible  person  will  grant  that  a 
good  digestion  of  vegetable  or  animal  food 
furnishes  sufficient  steam  and  stimulus 
for  the  physical  man  ;  that  a  good  di- 
gestion of  intellectual  food  (ideas)  fur- 
nishes  the    corresponding    requisites   for 


Nourishment  for  Man 


the  mental  man  ;  and  that  exalted  senti- 
ments are  the  pabulum  of   the  spiritual. 

Why  over-stimulate  the  physical,  and 
reflexively  degrade  the  mental  and  spirit- 
ual, by  indulgence  in  tea,  coffee,  beer, 
wine,  liquors,  opium,  tobacco,  etc.  ?  Over- 
stimulation will  bring  on  indigestion  ;  and 
prostration  will  follow  that.  Remember 
that  Nature  does  not  carry  long  credit  ac- 
counts. 

A  suggestion  for  the  selection  and 
preparation  of  physical  foods  is  here 
given  ;  this  book  being  hardly  the  place 
for  a  corresponding  list  of  mental  and 
spiritual  foods. 

FOODS  EASY  OF  DIGESTION. 


ARTICLES  OF  FOOD 


Venison  steak Broiled 

Pig's  feet  soused Boiled 

Brains Boiled 

Salmon,    tripe    or    trout 

(fresh) Boiled  or  fried 

Eggs,  fresh Whipped 

Rice Boiled 

Sago  or  barley Boiled 

Apples,  sweet  and    mel- 
low   Raw 

Tomatoes  or  lettuce. . .  ..Raw 
221 


HOW  PREPARED      TIME  OF  DIGESTION 
hour  30  minutes 
00 
45 


00 
30 
00 

45 

30 
30 


Intestinal  Ills 


ARTICLES  OF  FOOD  HOW  PREPARED 

Melons  or  watercress  ...  Raw 

1'eaelies,  plums  or  pears.. Raw  or  stewed 

Oranges  or  bananas Raw 

Asparagus  or  dandelion  .  .  Boiled 

Onions  or  apricots Stewed 

Mushrooms Roiled 

Cereal  coffee Boiled 

Blackberries 

Grape-nuts 

Lemons 

Watermelons 

Doxsee's  clam  juice  and 

little  neck  clams , 

Milkine,    Ilorlick's     and 

Mellin's  food 

Cereal  milk 

Armour  &  Co.'s  Vigoral. 
Valentine's     or    Wyeth's 

beef    juice     or    Wiel's 

beef  jelly i         "     oo 

FOODS  NOT  SO  EASY  OF  DIGESTION. 


riMF,  OF  DIGESTION 

hour  20  minutes 

"  30  " 

"  30  " 

"  30  " 

"  30  " 

"  30  " 

"  30  " 

"  30  " 

"00  " 

*'  00  " 

"  00  " 


30 
00 
00 


ARTICLES  OF  FOOD  HOW  PREPARED 

Beef Boiled 

Pig,  sucking Roasted 

Liver,  beef  (fresh) Broiled 

Lamb,  fresh Broiled 

Turkey,  domestic Roasted  or 

boiled 

"         wild Roasted 

Goose,         "    Roasted 

Chicken Fricasseed 

Codfish,  cured  and  dry... Boiled 
Oysters,  fresh Raw 


TIME  OF  DIGESTION 

2  hours  00  minutes 

2  "     30 

2  "00       " 

2  "     30 


30 

iS 
30 

45 
00 

35 


Nourishment  for  Man 


ARTICLES  OF  FOOD  HOW  PREPARED 

Hash  (chopped  meat  and 

vegetables) Warmed 

Eggs,  fresh Roasted 

"         " Raw 

Milk Boiled 

"    Uncooked 

Gelatine Boiled 

Custard Baked 

Tapioca  or  barley Boiled 

Beans,  green Boiled 

Sponge  cake Baked 

Apples,  sour  and  mellow.  Raw 
"         "      "   hard . . .  Raw 
Parsnips  or  green  corn  . .  Boiled 

Potatoes  and  yams Roasted   or 

baked 

Cabbage,  head Raw 

"           "    with  vine- 
gar   Raw 

Cauliflower Boiled 

Peas  (green)  or  squash.  .Boiled 
Cranberries  or  cherries.  .Stewed 

Rhubarb  or  figs Stewed 

Turnips Boiled 

Sprouts Boiled 

Raspberries Raw 

Dates Raw 

Buttermilk Raw 

Pumpkin Cooked 


TIME  OF  DIGESTION 


nutes 


2     hours  30  mini 

2           ' 

'       15         " 

2           * 

'      OO        " 

2           ' 

'       OO         " 

2            ' 

'       15          " 

2            ' 

'       30         " 

2            ' 

'     45       " 

2            ' 

1     00      " 

2           ' 

4     30      " 

2            ' 

'     30      " 

2           ' 

4    00      4< 

2           ' 

4     50      44 

2           4 

4     30      " 

2           ' 

«     30      " 

2            4 

.     3Q      .. 

2           ' 

*      OO         ,4 

2           * 

4      OO        " 

2           * 

4      OO        44 

2            ' 

4      OO         4* 

2           • 

4   30     44 

2            ' 

4   30     " 

2           ' 

4      OO         " 

2           ' 

*    00      44 

2           ' 

4      OO         4* 

2           ' 

4      OO         ,4 

2           * 

4      OO         4< 

FOODS   SOMEWHAT   DIFFICULT   OF  DIGESTION. 


ARTICLES  OF  FOOD             HOW  PREPARED  TIME  OF  DIGESTION 

Beef,  fresh,  lean Broiled  3     hours  00  minutes 

44         "         44    Roasted  3        4'     00      44 

223 


Intestinal  Ills 

ARTICLES  OF  FOOD  HOW  PREPARED 

Beef,  dry Roasted 

"      with  salt  only. . .  .Boiled 
"         "    mustard,  etc.  Boiled 

Pork,  steak Broiled 

' '      recen  tly  salted ....  Broiled 

"     ....Raw 
"  "  "  ..Stewed 

Mutton,  fresh Broiled 

"  "    Roasted 

"     Boiled 

Flounder,   fresh Boiled 

Oysters,  fresh Roasted 

"         "      Stewed 

Codfish  (salted)  or  white- 
fish Boiled 

Sausages,  fresh Broiled 

Rabbits Broiled 

Butter  or  cream 

Eggs,  fresh .Hard-boiled  or 

fried 
"    Soft-boiled 

Potatoes,  turnips  or  car- 
rots  Boiled 

Radishes  or  lentils Boiled 

Bread  (white)  fresh Baked 

"       whole  wheat Baked 

"       rye Baked 

"       graham Baked 

' '       corn Baked 

Corn  cake Baked 

Apple  dumpling Boiled 

Soup,  mutton  or  oyster. .  Boiled 

"      bean Boiled 

"      chicken Boiled 


TIME  OF  DIGESTION 

3 

hours  30  minutes 

3 

"     45       " 

3 

"     30       " 

3 

"     15       " 

3 

"     15       " 

3 

"     00       " 

3 

•*     00       ** 

3 

"     00       " 

3 

"     15       " 

3 

"00       " 

3 

."     30       " 

3 

11     ,5       ., 

3 

"     30       " 

3 

"     00       " 

3 

"20       " 

3 

"     00       " 

3 

"     00       " 

3 

•  <     30       .. 

3 

"     00       " 

3 

"     30       ■« 

3 

ii     30       .. 

3 

"     15       " 

3 

11     30       .. 

3 

"     30       " 

3 

•  1     30       .. 

3 

«     I5       .« 

3 

"     00       " 

3 

"     00       " 

3 

"     30       •'• 

3 

"     00       " 

3 

"     00       " 

224 

Nourishment  for  Man 


ARTICLES  OF  FOOD  HOW  PREPARED 

Chocolate  or  cocoa Boiled 

Currants  or  filberts 

Raisins   

Hazelnuts 

Peanuts Roasted 

Potatoes  (sweet) Roasted 

Walnuts 

Chestnuts Roasted 

Beans,  lima Boiled 

Zwieback 

Turkey Boiled   or 

roasted 

Eels. Fried 

Oleomargarine 

Cabbage Boiled 

Buckwheat  cakes 

Mutton,  lean Roasted 

Herring Broiled 

Cheese 


ARTICLES  OF  FOOD  HOW  PREPARED 

Beef,  fresh,  lean Fried 

"     old,  hard,  salted.  .Boiled 
"     recently  salted. ..  .Boiled 

"     Fried 

"     fat  or  lean Roasted 

"     suet  (fresh) Boiled 

"     soup    with  vegeta- 
bles and  bread Boiled 

Beef,  soup  from  marrow 

bones Boiled 

Pork,  fat  and  lean Roasted 

"     recently  salted. ..  .Boiled 
225 — 15 


TIME  OF  DIGESTION 

3     h 

Durs  00  minutes 

3 

"     00       " 

3 

"     00       " 

3 

"     30       " 

3 

"     00       " 

3 

"     00       " 

3 

M        30           " 

3 

"        15            " 

3 

"        OO           '* 

3 

"       OO         " 

3      to      4  hours 

3       ' 

'      4      " 

3       ' 

'      4      " 

3       ' 

'      4      " 

3       ' 

'      4      " 

3       ' 

'      4      " 

3#   ' 

'    \Yz  " 

VA  ' 

'      6      " 

DIGESTION. 

TIMI 

-  OF  DIGESTION 

4     hours  00  minutes 

4 

"       15         " 

4 

"       30         " 

4 

"       15          " 

5 

"       15         " 

5 

..       3Q         .. 

4 

44     15 

5 

"     i5 

4 

*'    00 

Intestinal  Ills 


ARTICLES  OF  FOOD  HOW  PREPARED 

Pork  recently  salted Fried 

ham Cured 

Veal Broiled 

"    Fried 

Mutton,  suet Boiled 

Fowls Boiled    or 

roasted 

Heart,  animal Fried 

Salmon,  salted,  or  mack- 
erel  Boiled 

Cabbage,  with  vinegar.  .Boiled 

Cheese,  old,  strong Raw 

Duck Roasted 


TIME  OF  DIGESTION 

hours  15  minutes 
"     30 
"     00 
"     30 


00 
00 


4         "00 
4         "     30 
"iVz  to  t]/2  hours 
4  hours  30  minutes 


826 


CHAPTER  XXIX. 

DIET  FOR   INDIGESTION. 

INDIGESTION  is  a  symptom  of  a 
*  functional  disturbance  or  is  due  to  a 
local  disease  in  some  portion  of  the  di- 
gestive apparatus.  Therefore  diet  must 
be  adapted  to  the  sensibility  of  the  stomach 
and  bowels,  to  gastric  and  intestinal  se- 
cretions, mobility,  absorption  and  elimi- 
nation, to  the  abnormal  increased  feeling 
of  hunger  or  to  the  absence  of  the  sensa- 
tion of  hunger. 

The  food  should  be  of  easy  solubility 
and  offer  slight  resistance  to  the  digestive 
juices.  It  should  not  mechanically  or 
chemically  irritate  or  impede  intestinal 
peristalsis.  It  should  not  increase  fer- 
mentation or  putrefaction  and  the  greater 
portion  of  it  should  be  absorbed 

The   object   of  diet  is   not  to  eat  less 

227 


Intestinal  Ills 

food  than  usual  but  to  secure  more  nour- 
ishment until  the  proper  quantity  is  con- 
sumed each  day.  The  restriction  of  foods 
does  not  mean  limitation.  Regular  hours 
for  meals  should  be  religiously  observed 
by  sufferers  from  indigestion.  The  food 
should  be  thoroughly  masticated.  Good 
judgment  should  be  used  by  each  individ- 
ual in  selecting  and  preparing  the  food- 
stuffs ;  also  in  the  amount  taken  at  each 
meal,  and  the  proper  length  of  time  to 
continue  the  diet. 

You  may  take  : 

Soup — in  moderate  quantity  :  Doxsee's 
clam  juice,  and  little  neck  clams  ;  cream 
of  peas,  etc.  ;  vermicelli  ;  tapioca ;  tomato  ; 
clear  soups  of  chicken,  beef,  mutton. 

Fish  :  trout ;  bass  ;  perch  ;  shad  ;  weak- 
fish  ;  whitefish  ;  smelts ;  raw  oysters. 

Meat :  roasted  or  boiled  beef  ;  mutton  ; 

venison  ;  calf's  head  ;  tongue  ;  sweetbread  ; 

lamb    chops  ;    squab ;    roasted    partridge  ; 

pigeon  ;  calf's-foot  jelly  ;  Armour  &  Co.'s 

Vigoral ;     Valentine's    or    Wyeth's    beef 

juice,  or  Wiel's  beef  jelly. 

228 


Diet  for  Indigestion 

Eggs  :  raw  ;  soft-boiled  ;  poached  ;  ome- 
lette ;  eggs  on  toast. 

Bread —  all  over   a   day  old :   brown 
graham  ;  gluten  ;  rye  ;  zwieback  ;  crackers 
cracked    wheat  ;    corn     meal  ;    hominy 
wheaten  and  graham  grits ;  rolled  rye  and 
oats  ;  granose  ;  cerealin  ;    macaroni    with 
toasted  bread-crumbs  ;  farina,  boiled  with 
milk  ;  Milkine  ;  Horlick's  or  Mellin's  food. 

Vegetables :  spinach  ;  green  peas  ;  greens  ; 
lettuce  ;  watercress  ;  sweet  corn  ;  aspara- 
gus ;  celery ;  artichokes  ;  baked  tomatoes  ; 
cauliflower. 

Dessert:  baked,  roasted  or  stewed  ap- 
ples ;  stewed  pears  or  peaches ;  baked 
bananas  ;  grapes  ;  oranges  ;  and  most  ripe 
fruits,  if  fresh. 

Beverages :  hot,  cool  or  cold  water  an 
hour  before  meals.  Drink  freely  of  the 
same  during  meal-time,  but  not  to  wash 
down  food.  Drink  also  :  cereal  coffee  ; 
buttermilk ;  koumiss  ;  fresh  cider  ;  bouillon. 

Avoid :    coffee  ;  tea  ;    milk  ;    ice-water  ; 
cocoa ;  chocolate  ;  malt  liquors  ;  spirituous 
liquors ;    sweet    and    effervescent   wines ; 
229 


Intestinal  Ills 

sugar;  candies;  foods  containing-  much 
starch  ;  rich  soups  ;  sauces  and  chowders  ; 
all  fried  foods  ;  hot  or  fresh  bread  ;  griddle- 
cakes  ;  doughnuts  ;  veal ;  pork ;  liver ;  kid- 
ney ;  hashes  ;  stews  ;  pickled,  canned, 
preserved  and  potted  meats  ;  turkey  ; 
goose  ;  duck  ;  sausage  ;  salmon  ;  salt  mack- 
erel ;  cabbage  ;  radishes ;  cucumbers ; 
cole-slaw  ;  turnips  :  potatoes  ;  beets  ;  pas- 
try ;  jellies  ;  jams ;  nuts. 


230 


CHAPTER   XXX. 

DIET    FOR    CONSTIPATION    AND    OBSTIPATION. 

DIET  is  too  often  a  makeshift  for  ig- 
norance, or  it  may  be  an  aid  until 
the  cause  of  indigestion  is  removed  ;  or  if 
not  curable,  a  compromise  effected  on  the 
best  possible  terms  for  continued  exist- 
ence. We  have  found  out  the  almost 
universal  cause  for  constipation,  obstipa- 
tion and  costiveness  ;  therefore  until  you 
can  have  the  proper  local  treatment  we 
suggest  the  following  foodstuffs,  trusting 
to  the  sufferer's  judgment  how  much  and 
how  often  to  take  the  nourishment. 

Coarse  foods,  stimulants  and  laxatives 
unduly  excite  the  bowels.  Avoid  them  if 
possible.  Be  regular  in  your  habits  as  to 
meal-times  ;  eat  three  times  daily,  and 
about  an  equal  amount  at  each  meal. 

You  may  take  : 

Soup:  all   kinds    of  meat   and  vegetable 
231 


Intestinal  Ills 

soup  ;    broth  ;     bouillon.        Reliable 
preparations  of  beef  juice,  jelly,  etc. 

Fish  :  all  kinds,  broiled  or  baked  ;  raw 
oysters  ;  Doxsee's  clam  preparations. 

Meat :  boiled  or  roasted  ;  poultry  ;  game, 
etc. 

Bread :  graham  ;  brown  ;  whole  wheat  ; 
corn  ;  rye  ;  ginger  ;  shredded-wheat 
biscuit. 

Cereals  :  wheaten  grits  ;  wheatena  ;  gran- 
ose  ;  oatmeal  porridge  ;  Milkine  ; 
Horlick's  and  Mellin's  food. 

Vegetables  :  cauliflower  ;  spinach  ;  beans  ; 
asparagus  ;    carrots  ;    onions  ;     Brus- 
sels   sprouts  ;    tomatoes  ;    peas  ;    cel- 
ery ;  cabbage. 
Vegetables    should    be    especially  well 

cooked  to  render  them  soft  and  easy  of 

digestion. 

Salads  ;  may  be  eaten  if  dressed  with  a 
generous  supply  of  olive  oil. 

Dessert :  oranges  ;  melons  ;  prunes  ;  tama- 
rinds ;  figs  ;  apples  (raw  or  baked)  ; 
pears  ;    plums  ;    peaches  ;    cherries  ; 

raisins  ;  stewed  fruit ;  honey  ;  black- 

232 


Diet  for  Constipation 

berries  ;  strawberries  ;  huckleberries  ; 
bananas. 
Some  may  find  it  advantageous  to  eat 
fruit  before  or  between  meals. 
Beverages  :  water  —  pure     spring    water 
preferably  ;    if    this    cannot    be   had, 
get,   if  possible,   distilled  water  that 
has  been  aerated  ;  buttermilk  ;  fresh 
cider  ;  beer  ;  ale. 
Mineral  waters  like  Hunyadi,  etc.,  irri- 
tate the  cause  of  constipation  (proctitis) 
in  a  way  similar  to  cathartic  remedies. 

Drink  a  tumbler  or  more  of  hot  or  cold 
water  an  hour  before  meals  —  preferably 
hot  water.  If  the  hot  water  be  distaste- 
ful add  a  little  salt.  Drink  freely  of  water 
about  the  temperature  of  6o°  during  the 
meals,  but  not  for  the  purpose  of  empty- 
ing the  mouth  of  food. 

On  retiring  at  night  and  rising  in  the 
morning  sip  slowly  from  a  quarter  to  half 
pint  of  water  (hot  or  cold).  In  the  morn- 
ing be  sure  to  rinse  the  mouth  free  of  the 
accumulated  mucus  before  drinking  the 
water. 
233 


Intestinal  Ills 

The  use  of  tea,  chocolate,  coffee  and 
alcoholic  drinks  is  so  abused  by  those 
even  who  consider  themselves  temperate 
in  their  habits,  that  I  recommend  these 
beverages  as  remedies  only  in  certain 
conditions   of   the   system. 

About  four  pints  of  pure  water  (t.  c,  free 
from  all  salts  or  other  foreign  ingredients) 
should  be  imbibed  in  twenty-four  hours. 
Avoid  :  sweets  ;  pastry  of  all  kinds  ;  pud- 
dings ;     rice  ;     milk ;     cheese ;     new 
bread  ;  nuts  ;  fried  foods  ;  rich  gravies ; 
farina  and  sago  puddings  ;  salt  meats  ; 
salt   fish  ;  veal  ;  goose  ;  liver  ;  hard- 
boiled   eggs  ;     pork  ;    tea  ;    tobacco  ; 
spirituous  liquors  ;    uncooked  straw- 
berries    and    huckleberries.      Avoid 
also  tomatoes  and  peaches  when  not 
fresh,  as  the  acid  generated  by  keep- 
ing them  a  few  days  is  very  irritating 
to  an  already  inflamed  bowel. 
Avoid  substances  that  would  inflame  the 
tissues  or  cause  congestion  of  any  organ  of 
the  body.      If  the  tongue  be  coated  avoid 

sugar,  starchy  foods  and  fresh  milk. 

234 


CHAPTER  XXXI. 

COSTIVENESS,   DIET,   ETC. 

TAKE  anything  in  the  way  of  food 
which  the  unconsciously  starved 
person  can  eat  without  the  stomach  and 
intestines  protesting  too  much ;  any  of 
the  foods  recommended  for  constipation, 
indigestion,  diarrhea ;  and  take  yet  more 
food  if  by  so  doing  there  is  a  gain  in 
flesh,  after  exercising  much  patience  as  to 
time. 

Irrigate  the  system  by  imbibing  freely 
of  hot  and  cold  water  at  various  periods 
of  the  day.  Good  red  wine  mixed  with 
the  water  drunk  at  meal-time  may  serve 
a  good  purpose  in  helping  to  enrich  the 
blood. 

Keep  the  pores  of  the  skin  open  by 
bathing  ;  and  all  the  functions  of  the  body 
active  by  exercise,  massage,  pure  air,  sun- 
light, rest,  sleep  and  seasonable  clothing. 

235 


Intestinal  Ills 

The  large  intestines  should  be  kept 
clean  by  proper  amounts  of  water  injected 
into  them.  The  local  cause  of  all  the 
trouble  should  be  treated  by  a  competent 
physician. 

And  with  all  the  efforts,  continue  the 
treatment  long  enough  to  accomplish 
some  eood  and  then  a  much  longer  time 
to  get  well.  Do  not  give  up  treatment 
under  which  you  have  improved  if  it  re- 
quires one,  two  or  three  years  to  accom- 
plish what  you  have  so  well  started  out 
to  do. 


2-tf 


CHAPTER  XXXII. 

DIET   FOR   DIARRHEA. 

A  PERIOD  marked  by  constipation, 
biliousness  or  poisons  generated 
within  or  taken  into  the  intestinal  canal 
is  often  followed  by  diarrhea.  Mental 
excitement  will  induce  it  in  some  persons. 
More  often  man's  early  and  most  com- 
mon malady,  proctitis,  is  the  direct  or  in- 
direct cause.  Some  forms  of  ulceration 
of  the  lower  bowel  induce  diarrhea. 
Chronic  cases  of  diarrhea  usually  follow 
the  decline  of  vitality  marked  by  the 
symptom  of  Costiveness,  which  means  the 
interruption  of  all  the  functions  of  nutri- 
tion. The  intestinal  canal  is  then  like  a 
rubber  tube  with  the  contents  hurried 
through  it.  The  whole  system  is  irritable 
as  the  result  of  an  accumulation  of  sec- 
ondary symptoms  expressed  by  the  word 
auto-intoxication. 
237 


Intestinal  Ills 

The  food  should  be  nutritious  and  non- 
irritating  to  the  intestinal  canal. 

Reliance  must  be  placed,  in  severe 
cases,  on  liquid  foods  and  beverages. 

The  more  solid  foods  may  be  taken  in 
limited  quantity  as  the  recovery  progres- 
ses. In  more  acute  cases  it  is  well  to  stop 
all  food  for  twelve  or  twenty-four  hours. 

You  may  take  : 

Liquid  Food  and  Beverages :  Drink,  if 
possible,  pure  spring  water.  If  this  can- 
not be  obtained,  sterilize  the  water,  or 
distil  and  aerate  it ;  it  must  be  pure  and 
soft.  Better  still :  drink  toast-  or  rice- 
water  ;  kefyr,  four  days  old ;  koumiss  ; 
lactic-acid  water  ;  zoolak  ;  egg  lemonade  ; 
sterilized  milk  with  one  third  lime-water ; 
whortleberry  wine  ;  acorn  cocoa ;  unfer- 
mented  grape-juice. 

Soup :  chicken  ;  mutton  ;  clam  ;  oyster 
broth  ;  Doxsee's  clam-juice  ;  bouillon  ; 
Milkine  ;  Horlick's  and  Mellin's  food. 

Meat :  minced  chicken  ;  scraped  beef  ; 

roast  fowl ;  beef  steak  ;  fillet  of  beef  ;  raw 

beef ;  sweetbread  ;  raw  oysters. 

23S 


Diet  for  Diarrhea 

Eggs :  lightly  boiled,  poached. 

Cereals  and  Fruit :  grapes  at  all 
hours,  eaten  without  seeds  or  skin  ;  arrow- 
root ;  tapioca  ;  sago  ;  barley  mush  ;  maca- 
roni ;  rice  boiled  with  milk ;  milk  toast ; 
dry  toast ;  crackers  ;  junket ;  bread  pud- 
ding ;  egg  pudding,  not  sweetened  ;  hasty 
pudding,  with  flour  and  milk ;  mashed 
potatoes. 

Avoid :  pork  ;  veal  ;  nuts  ;  salt  meats  ; 
fish ;  fried  foods  ;  sugary  foods  ;  fruits, 
cooked  or  raw  ;  oatmeal  ;  brown  and  gra- 
ham bread  ;  new  bread  ;  vegetables  ;  and 
most  soups. 


239 


A  FINAL  WORD  TO   THOSE  TO 

WHOM  I   HAVE  DEDICATED 

THIS  BOOK. 

TT  is  very  evident  from  the  perusal  of 
*  this  work  that  the  symptoms  of 
proctitis,  both  general  and  local,  proceed 
from  no  trifling  disease  ;  and  also  that  the 
disease  may  have  existed  for  a  very  long 
time,  perhaps  as  much  as  twenty,  forty  or 
more  years.  During  the  greater  part  of 
its  existence  all  sorts  of  medication  have 
been  tried  to  allay  this  or  that  annoying 
prominent  symptom  with  a  hope  of  a  cure. 

At  the  congress  of  physicians  that  met 
in  Paris  in  1900,  one  of  the  subjects  dis- 
cussed was  chronic  constipation  and  their 
"  wise  "  conclusion  was  that  man  needed 
more  grease,  therefore  they  mourned  the 
loss  of  the  frying-pan. 

Symptoms  induced  by  proctitis  in  vari- 
ous parts  of  the  body  are  often  accom- 
panied by  painful  local  symptoms,  called 

240 


A  Final  Word 

piles  or  a  "  touch  of  the  piles."  Then 
local  medication  is  added  to  the  general 
treatment,  and  as  usual  matters  go  from 
bad  to  worse.  Physicians  consulted  have 
been  honest  and  kind,  but  with  all  their 
advice  the  increasing  troubles  continue. 
Your  demands  grow  more  pressing  on 
your  doctor  and  as  a  last  resort  he  men- 
tions a  surgical  operation  for  the  removal 
of  one  or  more  painful  local  symptoms. 
The  fright  is  sufficient  in  most  cases  to 
make  the  sufferer  endure  the  ills  he  has 
rather  than  flee  to  others  he  knows  not, 
even  risking  life  itself.  Others  more  bold 
submit  to  an  examination  by  the  surgeon, 
which  proves  so  painful  at  the  time  and 
causes  so  much  subsequent  suffering  that 
they  are  now  really  content  not  to  impor- 
tune any  more  for  help. 

A  few  in  desperation  make  up  their 
minds  to  have  the  local  anal  symptom  re- 
moved regardless  of  the  final  result. 

Thus  millions    of   human  beings  have 

suffered  and  died  and  countless  numbers 

are  enduring  the  ills  they  have,  not  know- 
241 — 16 


Intestinal  Ills 

ing  of  a  rational  and  humane  system  of 
treatment ;  a  treatment  that  not  only  re- 
moves the  numerous  annoying  symptoms, 
but  the  cause  as  well ;  a  system  that  will 
stand  the  test  of  time,  of  common-sense,  of 
constant  investigation  to  know  the  why 
and  wherefore  of  both  disease  and  treat- 
ment. 

For  over  twenty  years  I  have  concerned 
myself  with  this  and  allied  ailments,  and 
have  treated — without  the  use  of  the  knife 
— all  cases  of  piles,  polypus,  fissure,  strict- 
ure, ulcerations,  etc.  At  the  present  time 
physicians  are  writing  me  in  this  wise : 
"  I  want  to  take  a  course  of  instruction 
from  you.  I  have  performed  some  suc- 
cessful surgical  operations  on  the  rectum, 
but  it  is  not  profitable  ;  the  people  will 
not  submit  to  it."  Another  writes  :  "  Your 
treatment  of  hemorrhoids  has  been 
brought  to  my  notice  by  my  friend  and 

patient,    Mr. .      The  method  you 

practise  is  certainly  an  ideal  one  and  seems 
to    have   been    most    successful    in    your 

hands,  and  I  would  like  to  adopt  it." 

242 


A  Final  Word 

To  physicians  and  laymen  interested,  I 
will  send,  for  twenty-five  cents,  my  treatise 
on  Diseases  of  the  Anus  and  Rectum  (en- 
titled How  to  Become  Strong).  It  con- 
tains over  ioo  anatomical  illustrations, 
and  125  testimonials,  and  forms,  there- 
fore, a  valuable  adjunct  to  this  volume. 

All  whose  testimonials  appear  in  the 
64-page  book  suffered  from  proctitis  to  a 
greater  or  less  extent  and  with  the  excep- 
tion of  a  few  all  suffered  from  chronic 
constipation,  indigestion,  etc. 

Surgeons  usually  desire  strong  and  vig- 
orous patients.  The  author  asks  merely 
for  an  intelligent  patient,  or  for  some  one 
to  direct  the  home  attention  necessary 
between  treatments. 

This  book,  as  well  as  the  one  entitled 
Hoiv  to  Become  Strong,  and  the  author's 
other  printed  instructions,  are  the  result 
of  his  desire  to  make  his  patients  intelli- 
gent on  the  subject  of  the  disease  and 
symptoms  for  which  they  seek  his  assist- 
ance.    They  truly  cannot  know  too  much 

for  their  own  good  in  this  regard  ;  an  ig- 
243 


Intestinal  Ills 

norant  patient  can  not  do  justice  either  to 
himself  or  to  his  physician.  Those  who 
have  tried  all  the  fads  and  so-called  cures 
in  order  to  relieve  their  troubles  will  cer- 
tainly appreciate  what  I  have  here  pre- 
sented for  their  study.  With  enlightenment 
comes  the  desire  to  set  things  right. 
So  I  have  no  appeal  to  make  to  the  lazy : 
I  shall  leave  them  to  their  ills  and  their 
pills.  And  for  those  who  appreciate  the 
beauty  of  cleanliness,  both  external  and 
internal,  I  shall  write  another  book  on 
that  subject,  including  a  prophecy  for 
coming-  generations.  Eternal  vigilance 
is  the  price  we  must  pay  if  we  would  en- 
joy the  highest  physical,  mental  and  spir- 
itual expression  of  our  personalities. 

Thanking  the  indulgent  reader  who  has 
read  my  description  of  Intestinal  Ills,  I 
advise  him  to  rewrite  it  in  his  own  organ- 
ism, if  not  in  printer's  ink  :  the  world  will 
be  better  for  it ! 


244 


INTESTINAL  ILLS. 


NO.  i. 


Chronic  Constipation  and  the  Use  of 
the  Enema. 

CIVILIZED"  man  is  the  victim,  by 
inheritance  from  distant  ances- 
tors, of  undesirable  characteristics,  traits, 
and  tendencies.  While,  dining  the  long 
process  of  evolution,  some  of  the  cruder 
features  of  the  physical  and  mental  traits 
have  been  refined  or  eliminated,  the  mod- 
ern man  still  clings  to  certain  habits  in- 
herited from  his  wholly  animalistic  days. 
Even  as  the  man  of  that  day,  so  the  man 
of  to-day  eats  far  too  much  and  far  too 
frequently. 

To  the  scientific  eye,  your  capacious 
digestive  apparatus  is  a  psycho-physical 
exhibit  of  the  racial  proclivity  to  overeat. 
245 


Intestinal  Ills 

Here,  in  this  exhibit,  the  race's  inordinate 
craving  for  food  and  drink,  its  gluttonous 
thought,  have  embodied  themselves;  and 
this  exhibit,  this  apparatus,  is  accord- 
ingly not  merely  physical,  but  also  psy- 
chical, for  its  sub-conscious  outreach  for 
"more  and  always  more"  is  only  too 
apparent.  Man's  stomach  and  bowels 
are  too  much  like  those  of  a  mere  animal, 
and  are  the  source  of  nine-tenths  of  his  ills. 
All  great  consumers  of  foodstuffs,  Na- 
ture declares,  should  walk  on  all  fours ;  if 
you  will  persist  in  walking  on  your  hind 
legs,  you  will  have  to  pay  the  penalty. 
You  will,  moreover,  contract  other  habits 
not  conducive  to  real  animal  health.  And, 
as  Nature  predicted,  man's  social  customs 
to-day  are  out  of  all  accord  with  glutton- 
ous feeding;  he,  as  well  as  his  capacious 
bowels,  suffers  the  consequences  of  his 
excessive  feeding,  and  this  suffering  leads 
him  to  adopt  artificial  means  for  relief  or 
escape.  Up-to-date  civilization  has  con- 
strained man  to  adopt  a  cooped-up  exist- 
ence, one  that  shuts  out,  to  a  great  extent, 

246 


Chronic  Constipation 

sunshine  and  air;  an  existence,  moreover, 
that  involves  but  a  limited  amount  of 
exercise.  How,  then,  can  it  be  otherwise 
than — gormand  that  he  is — that  he  should 
fare  ill  with  this  gluttonous,  mammoth 
digestive  canal? 

Man  is  not  as  yet  more  than  half 
human,  and  he  will  not  become  truly 
human  until  he  makes  more  use  of  the 
upper  lobes  of  his  brain,  nor  until  the 
spiritual  part  of  his  nature  becomes  domi- 
nant. When  that  day  dawns  he  will  have 
a  corresponding  evolution  of  the  physical 
body,  especially  of  the  gastro-intestinal 
canal.  Some  one  has  sagely  said  that 
man's  brain  is  a  mere  extension  of  his 
intestinal  canal.  Well,  possibly  by  and 
by  the  intestinal  canal  may  become  an 
extension  of  a  spiritually  awakened  mind, 
with  all  its  dominating  influence  over  the 
physical  body.  Surely  the  evolutional 
trend  from  animal  to  complete  manhood 
may  be  aided  by  intelligent  foresight  as 
to  bodily  care  and  hygiene. 

Cooped  up  like  a  canary  bird,  or  penned 
247 


Intestinal  Ills 

up  and  fattening  like  a  hog,  with  his 
enormous  eating  capacity  and  vast  in- 
testinal storage  space,  poor  man  has 
matters  made  worse  by  having  his  several 
orifices  liable  to  inflammatory  invasions. 
He  does  not  seem  able  to  escape  from 
his  enemies  anywhere. 

The  mucous  membrane  lining  the  ori- 
fices of  the  body  is  nothing  more  than 
the  skin  turned  in  to  line  canals  for  air, 
gases,  liquids,  and  solids  to  pass  in  and 
out  in  order  to  keep  up  the  physio-logical 
functions  of  the  body.  Very  rarely,  in- 
deed, do  we  find,  from  childhood  to  old 
age,  the  orifice  of  the  intestinal  sewer 
otherwise  than  chronically  inflamed,  the 
invasion  extending,  moreover,  the  whole 
length  of  the  rectum  for  some  distance 
into  the  sigmoid  colon. 

It  is  no  trifling  matter  to  have  the 
function  of  some  thirty  feet  of  the  gastro- 
intestinal tract  disturbed,  especially  of 
the  large  intestine — some  five  feet  in 
length,  two  and  a  half  inches  in  diameter 

in  not  a  few  sections. 

248 


Chronic  Constipation 

Almost  without  exception,  we  find  the 
lower  portion  of  the  intestinal  sewer  the 
seat  of  chronic  inflammation  that  extends 
into  the  sigmoid  colon;  and,  as  an  inevit- 
able result  of  the  inflammation,  contrac- 
tion more  or  less  permanent  has  taken 
place  in  the  circular  and  longitudinal 
muscular  bands  that  form  its  structure. 
The  constriction  is  especially  severe  at 
the  junction  of  the  rectum  with  the  sig- 
moid colon,  where  it  flexes  upon  itself  in 
the  region  where  the  bore  of  the  rectum 
is  less.  The  comparative  shutting  up  of 
the  caliber  of  the  upper  end  of  the  rectum 
and  lower  portion  of  the  sigmoid  colon 
occasions  undue  retention  of  the  feces 
and  gases  which  accumulate,  and  in  ac- 
cumulating dislocate  various  portions  of 
the  large  intestine,  thus  forming  pouches, 
sacks,  reservoirs,  prolapse,  etc.,  which 
hold  the  products  of  putrefaction  as  well 
as  the  irritating,  poisonous  mucus  thrown 
out  from  the  inflamed  tissue. 

I  regard  the  occlusion  of   the   upper 

portion  of  the  rectum,  and  especially  of 
249 


Intestinal  Ills 

the  region  involved  in  the  flexure  of  the 
bowel,  as  the  most  usual  seat  and  source 
of  constipation.  Not  so  very  long  ago  it 
was  the  custom  to  stretch  the  sphincter 
muscles  for  the  "cure"  of  constipation; 
at  the  present  time  the  "cure"  is  found 
in  the  valves  of  the  middle  lower  portion 
of  the  rectum.  The  folly  of  these 
"cures"  becomes  apparent  when  we  un- 
derstand that  the  parts  treated  were 
neither  the  seat  nor  the  source  of  con- 
stipation. I  have  always  regarded  great 
retention  of  feces  in  the  rectum  as  im- 
paction in  a  delivery  canal,  due  to  con- 
traction of  the  anal  muscles,  not  as 
constipation,  which  can  only  take  place 
in  the  temporary  storage-place — the  sig- 
moid flexure.  The  lower  two- thirds  of 
the  rectum  plays  no  part  in  constipation 
of  the  bowels. 

Form  a  manikin,  made  out  of  very 
thin,  soft  rubber  tubing,  to  represent  the 
stomach  and  small  and  large  intestine, 
holding  the  various  parts  in  place  with 

elastic   bands,  and   cotton   to   represent 

250 


Chronic  Constipation 

fat.  When  all  portions  are  properly  and 
anatomically  placed  close  the  lower  eight 
or  ten  inches  of  the  manikin,  representing 
the  lower  portion  of  the  sigmoid  colon, 
rectum,  and  anus,  just  as  tightly  as  we 
should  find  it  closed  in  sufferers  from 
chronically  acute  proctitis  and  colitis. 
Now  insert  at  the  stomach  portion  of 
the  manikin  a  generous  amount  of  man's 
usual  mixture  of  foodstuffs  and  liquids, 
and  repeat  the  supply  three  or  four  times 
during  the  day  (without  any  previous  at- 
tempts at  cleansing),  and  then  note  the 
fermentative  and  putrefactive  changes 
that  take  place;  the  ensuing  bacterial 
poisons  and  the  great  volume  of  poison- 
ous gases — all  of  which  occasion  squirm- 
ing, twisting  movements  of  the  manikin 
as  dislocations  here  and  there  occur,  as 
pouches  and  reservoirs  develop,  as  the 
walls  become  distended  with  gas  and 
putrid  substance;  and  then,  time  elaps- 
ing, the  usual  foodstuffs  are  added  to 
the  foul  mass  within!  Now,  if  there  is 
any  pity  in  your  soul,  you  medical  man, 
251 


Intestinal  Ills 

for  the  enfouled  and  deformed  human 
manikin,  you  will  want  to  wash  it  out 
with  cleansing  water  before  its  structure 
comes  to  an  untimely  end.  We  medical 
men  all  know  the  numerous  and  grave 
symptoms  exhibited  by  one  or  more 
organs  of  the  body,  or  by  all  of  them, 
from  the  persistent  work  of  the  deleteri- 
ous gases  and  bacterial  poisons  on  the 
system — a  work  going  on  for  years,  finally 
placing  the  victim  beyond  medical  aid. 
All  of  us  are  agreed  that  the  capacious 
gastro-intestinal  canal  should  be  clean. 
What,  I  submit,  is  the  best  means  of 
keeping  clean  this  long,  large,  tortuous, 
spacious,  valved  and  flexed  canal  —  a 
canal  that  disease  has  here  and  there 
pouched,  dislocated,  bagged,  reservoired; 
a  canal  at  whose  lower  end  a  great  cess- 
pool exists;  that,  like  other  portions  of 
the  gut,  is  never  empty  and  clean — what 
is  the  best  means  but  a  flushing  with 
copious  amount  of  water? 

Proctitis  or   colitis  is  a  very  serious 

disease;  like  a  railroad  injury,  it  is  found, 

252 


Chronic  Constipation 

on  examination,  to  be  much  worse  than 
appearances  at  first  indicated. 

A  physician  who  prescribes  for  a  case 
of  chronic  constipation  or  diarrhea  with- 
out first  examining  the  sufferer  for  proc- 
titis and  colitis,  is  either  ignorant  or 
does  wilful  harm  to  his  patient  and  injury 
to  his  practice.  The  abominable,  aborigi- 
nal and  almost  universal  custom  at  the 
present  time  of  giving  some  physic  to 
"cleanse"  the  gastro-intestinal  canal  is  in 
every  respect  a  deplorable  mistake  for  a 
conscientious  doctor  to  make. 

Many  persons  suffering  from  chronic 
constipation  drink  very  little  or  no  water. 
As  a  consequence,  they  are  a  sort  of 
dirty,  dried-up  plant,  with  but  little  juice 
of  life  in  them. 

Others,  again,  equally  unclean,  or  more 
so,  take  a  moderate  amount  of  fluid  every 
day,  and  present  a  more  or  less  roly-poly 
appearance,  with  considerable  abdominal 
distention,  due  to  malnutrition  and  gases. 
Of  course,  their  eyes,  skin,  tongue,  breath, 
and  lack  of  vim  and  vigor  tell  the  story 
253 


Intestinal  Ills 

of  a  long  process  of  self-poisoning,  with 
every  now  and  then  the  eventuation  of  a 
storm  of  foulness,  called  a  bilious  attack 
• — meaning  an  overflow  of  filth.  Death 
often  brings  about  a  radical  change  in 
such  poisoned  bodies. 

Now,  what  can  a  prescriber  of  a  gastro- 
intestinal ejector  expect  to  accomplish 
by  disturbing  the  maleconomy  of  this 
apparatus?  Usually  he  expects  that  con- 
siderable trouble  will  ensue ;  consequently, 
he  will  add  belladonna  or  some  other 
soothing  drug  to  mitigate  the  act  of 
expulsion.  The  ejector  (called  laxative, 
purgative,  cathartic)  occasions  irritation, 
which  sets  up  twisting,  writhing,  rumbling 
of  the  bowels,  accompanied  with  a  shower 
of  liquid  into  the  canal  (as  tears  fill  the 
eyes  from  the  effects  of  sand  or  a  blow), 
which  liquid  mingles  again  with  the 
putrid  refuse  materials,  from  which  it  had 
been  recently  absorbed,  and,  mingling, 
proceeds  to  fill  up  the  normal  and  ab- 
normal spaces  just  described,  to  be  again 
reabsorbed  into  the  system.     Oh,  the  foul- 

254 


Chronic  Constipation 

ness  of  it  all !  The  spirits  of  the  departed, 
as  well  as  the  still  incarnate  patients, 
demand  of  the  healing  art  safe  and  sane 
hygienic  methods  of  cure.  The  enema, 
regularly  and  properly  used,  is  the  remedy 
par  excellence. 

Those  that  suffer  from  chronic  consti- 
pation are  usually  deficient  in  the  quan- 
tity and  quality  of  intestinal  secretions. 
Physic  increases  the  depletion  of  the 
intestinal  juices.  Of  the  watery  secretion 
forced  into  the  bowels,  four-fifths  are 
reabsorbed  into  the  system,  plus  poisons 
and  filth.  The  system  soon  becomes 
accustomed  to  the  irritation  of  drugs, 
and  requires  an  ever-increasing  amount. 
These  irritate  and  increase  the  chronic 
inflammation  of  the  lower  bowel,  often  to 
the  extent  of  a  discharge  of  blood. 

Straining  effort  to  induce  defecation  is 
injurious.  The  use  of  massage,  of  vibra- 
tory exercises,  of  electricity ;  the  spraying 
of  cold  water  on  the  abdomen,  etc., — 
none  of  them  are  calculated  to  remove 
or  even  to  relieve  the  proctitis  and  colitis. 

*5S 


Intestinal  Ills 

The  temperature  of  the  water  used  for 
an  enema  should  be  about  one  hundred 
degrees.  It  should  be  taken  at  least  twice 
daily,  preferably  on  retiring  at  night  and 
soon  after  breakfast,  at  regular  times,  if 
possible.  Such  practice  obviates  the 
need  of  large  injections. 

In  beginning  the  use  of  the  enema  it 
is  well  to  inject  from  a  half  to  a  pint  of 
water,  and  expel  it.  This  constitutes  a 
preliminary  injection.  Frequently  it  is 
desirable  to  take  another  preliminary  in- 
jection before  taking  the  large  one,  which 
latter  is  variously  called  "flushing  the 
colon,"  "taking  an  enema,"  "taking  an 
internal  bath"  or  "a  washout,"  etc. 
It  is  essential  first  to  get  rid  of  the  feces 
and  gases  in  the  rectum,  so  that  they  be 
not  sent  back  when  you  proceed  to  flush 
the  colon. 


256 


NO.  2. 

Objections  to  the  Use  of  Enema 
Answered. 

HTHE  privilege  of  raising  objections  be- 
*  longs  to  the  ignorant  as  well  as  to  the 
intelligent.  But  the  objector  is  under  as 
great  obligations  to  state  his  reasons  as 
the  advocate. 

The  first  plausible  objection  to  the  use 
of  the  enema  is  that  it  is  not  natural. 

Admitting  this  charge,  I  should  say 
that,  inasmuch  as  proctitis,  colitis,  and 
constipation  are  unnatural,  the  use  of 
a  preternatural  or,  in  other  words,  a 
rational  means  to  overcome  the  conse- 
quences of  these  diseases  is  imperative. 
The  enema  is  such  a  means. 

Can  any  one  that  suffers  from  proc- 
titis, etc.,  have  a  natural  stool?  Un- 
257 


Intestinal  Ills 

natural  conditions  require  preternatural 
aids,  as  we  all  know.  The  injected  water 
dilates  the  constricted  portion  of  the  gut 
and  arouses  a  revulsive  impulse  to  expel 
the  invading  water.  In  obeying  this  im- 
pulse the  imprisoned  feces,  gases,  etc.,  are 
ejected  with  the  water. 

It  may  be  unnatural  to  put  water 
into  the  rectum,  etc.,  but  once  there 
its  expulsion  from  healthy  bowels  would 
be  quite  natural.  No  natural  action 
can  be  expected  from  unhealthy  bowels ; 
they  do  the  best  they  can  under  the 
circumstances.  Eye-glasses,  false  teeth, 
crutches,  etc.,  are  unnatural  but  invalu- 
able aids,  but  no  more  so  than  is  the 
enema  as  a  means  of  relief  from  overloaded 
bowels.  The  enema,  moreover,  be  it 
noted,  not  only  aids  the  system  by  re- 
lieving it  of  its  loads;  it  cleanses  and 
soothes  an  organ  that  must  be  kept  at 
work  and  perform  its  functions  even 
when  invaded  by  disease. 

Surely  it  is  unhygienic  and  irrational  to 

ignore  the  valuable  service  of  the  enema 

258 


Chronic  Constipation 

in  cases  in  which  the  bowels  are  in  an  un- 
natural condition.; 

The  second  objection  is  that  the  water 
will  wash  away  the  mucus  from  the  mu- 
cous membrane  of  the  bowels  and  leave 
them  dry  and  parched,  and  thus  apt  to 
crack  and  break  in  two.  I  would  remind 
the  objector  that,  since  about  75  per  cent. 
of  the  normal  feces  is  water,  it  seems 
strange  that  so  great  a  quantity  of  water 
in  contact  with  the  mucous  surface  of 
the  bowels  should  not  also  cause  dryness. 

The  integument  of  the  body  and  that 
of  the  mucous  membrane  are  similar  in 
structure,  yet  whoever  had  a  fear  of  pro- 
ducing dryness  of  the  skin  by  much 
application  of  water?  The  mucous  mem- 
brane is  simply  the  skin  turned  inward; 
and  since  it  is  much  more  vascular  it  is 
less  apt  to  become  dry — if,  indeed,  its 
dryness  were  at  all  possible .  The  ob j  ect or 
should  also  remember  that  the  body  is 
composed  of  over  80  per  cent,  of  water — 
an  organism  not  to  be  made  dry  or  parched 

by  the  application  of  water  to  the  skin 
259 


Intestinal  Ills 

or  to  the  mucous  membrane  two  or  three 
times  a  day. 

The  mucous  membrane  of  the  lower 
bowel  is  not  unlike  that  of  the  mouth, 
throat,  or  stomach.  Do  you  realize  how 
often  the  upper  end  of  the  intestinal  canal 
is  washed  or  bathed  daily  with  liquids, 
soft  and  hard  drinks,  hot  and  cold,  espe- 
cially by  those  who  have  formed  the 
drink  habit  instead  of  the  enema  habit? 

They  have  no  fear  of  drying  the  mucous 
membrane  thereby;  but  if  you  can  instil 
this  fear  they  will  increase  the  quantity 
with  pleasure. 

This  second  objection,  being  the  result 
of  too  vivid  an  imagination  and  too  little 
reflection,  is  a  very  nonsensical  objection 
indeed. 

A  third  objection  is  that  if  you  begin 

the  use  of  the  enema  you  will  have  to 

continue  its  use;  you  can't  stop,  and,  lo 

and  behold !  the  enema  habit  is  formed — ■ 

a  new   habit   in   addition   to   the   many 

habits  civilized  man  is  already  carrying; 

the  constipated  habit,  the  physic  habit, 

260 


Chronic  Constipation 

the  sand,  bran,  sawdust-food  habit,  the 
muscular  peristaltic  habit,  etc.— and  with 
all  these  habits  the  poor  victim  of  proctitis 
and  intestinal  foulness  wonders  that  he  is 
alive. 

Usually  the  first  symptom  of  proctitis 
is  constipation,  and  for  relief  the  enema 
habit  should  be  formed  and  continued 
while  the  constipation  remains.  When 
the  proper  means  are  found  to  remove  the 
intestinal  inflammation — proctitis  and  co- 
litis— then  the  constipation  will  disappear, 
and  with  its  disappearance  the  enema 
habit  can  be  discontinued.  But  let  it 
be  well  noted  that  the  enema  is  itself  an 
aid  in  curing  the  cause,  an  aid  superior 
to  any  other  at  our  command.  A  cleanly 
habit  ought  not  to  be  an  objectionable 
one,  especially  in  cases  in  which  it  is  most 
needed  to  prevent  toxic  substances  from 
entering  the  system. 

A  fourth  objection  is  that  after  taking 
the  first  enema  the  constipation  is  worse. 

With  many  persons  a  certain  amount 

of  undue  accumulation  of  feces  will  excite 
261 


Intestinal  Ills 

a  sufficient  muscular  effort  of  the  gut  to 
force  the  dried  mass  through  the  proctitis- 
and  colitis-  strictured  bowels.  This  un- 
natural effort  may  occur  once  a  day  or. 
once  in  two  or  three  days,  and  has  doubt- 
less been  a  habit  of  many  years'  duration. 

To  introduce  a  new  order  of  conduct 
on  the  part  of  the  bowels  requires  time. 
If  the  bowels  have  been  in  the  habit  of 
expelling  feces  in  the  morning,  and  an 
enema  were  taken  the  night  before,  there 
might  be  no  desire  to  stool  the  next  morn- 
ing because  of  the  fact  that  the  bulk 
or  accumulated  mass  of  excrement  was 
no  longer  there  to  create  a  vigorous  call 
or  impulse  for  defecation. 

But  we  have  found  the  extent  of  local 

damage  and  reflex  to  the  organs,    and 

more  especially  the  constant   absorption 

of  poisons  into  the  system,  due  to  the 

presence  of  feces.     It  is  for  this  reason 

that   the   elimination   of  feces   twice   or 

thrice  in   twenty-four  hours  is  advised. 

The  condition  for  which  an  enema  is  used 

is  one  of  disturbance  and  poison  to  the 

262 


Chronic  Constipation 

system.  It  is,  therefore,  a  most  unnatural 
condition.  What  is  more  rational,  con- 
sequently, than  to  employ  an  ' '  unnatural ' ' 
yet  not  harmful  means  to  bring  about 
a  more  normal  condition,  one  free  from 
poisoning  and  irritating  consequences? 

A  fifth  objection  is  made  by  those  who 
have  as  a  symptom  of  proctitis  a  large 
development  of  pile  tumors  or  hemor- 
rhoids (distended  mucous  membrane). 
The  objection  is  that  at  times  these 
tumors  or  sacs  prolapse  very  freely  dur- 
ing the  act  of  expelling  the  injected 
water.  But  this  prolapse  occurs  in  many 
cases  whether  water  is  used  or  not. 

A  certain  amount  of  anal  irritation 
caused  by  the  passage  of  feces  occurs, 
causing  contraction  of  the  circular  mus- 
cular tissue  that  forms  the  anal  and  rectal 
canal,  also  of  the  longitudinal  muscular 
bands  and  the  levator  muscles  of  the 
organs.  The  enema  lessens  or  entirely 
diminishes  the  irritation  of  passing  feces, 
and  the  natural  result  is  that  the  serum - 

filled   sacs,   called  piles,  and  the  tissue 
263 


Intestinal  Ills 

loosened  by  the  inflammatory  product 
will  more  readily  prolapse  during  the  act 
of  defecating.  It  is  simply  a  choice  be- 
tween irritation  of  the  stool  keeping  the 
tissue  up  and  no  irritation  permitting  a 
prolapse. 

Of  course,  if  there  be  no  expulsion  of 
feces  and  water  the  stretched  or  dilated 
sacs  may  keep  their  places  in  the  rectum. 
And  then  again,  the  enema  may  be  used 
for  quite  a  period,  when  all  at  once  a 
large  prolapse  of  sacculated  mucous 
membrane  occurs,  and  the  enema  is 
thought  to  be  the  cause  of  it.  That 
this  is  not  the  cause,  let  it  be  remem- 
bered that  in  all  cases  of  proctitis  the 
chronic  inflammation  is  apt  to  become 
subacute  or  acute,  and  that  this  intense 
engorgement  and  enlargement  of  the 
tissue  with  blood  and  the  increased  fever 
in  the  parts  often  result  in  prolapse  at 
any  time,  especially  at  times  of  convul- 
sive effort  at  evacuation. 

Whatever  follows  the  proper  use  of  an 

enema,  even  though  what  follows  be  an- 

264 


Chronic  Constipation 

noying,  should  not  be  blamed  on  the 
enema,  for  its  action  is  most  kindly,  les- 
sening as  it  does  the  irritation  that  other- 
wise would  be  more  severe  when  the  feces 
pass  through  a  disease-constricted  canal. 

The  sixth  objection  is  that  the  use  of 
the  enema  will  weaken  the  bowels,  which 
are  already  too  "weak"  to  expel  their 
contents.  "Atony,  paralysis,  fatty  de- 
generation of  the  gut,  are  bad  enough," 
say  these  objectors,  "without  having  an 
enema  increase  their  uselessness. "  Di- 
agnosis wrong  and  objection  groundless. 

Distend  and  contract  an  organ  for  a 
short  time  two  or  three  times  a  day,  and  it 
will  gain  in  strength  from  the  exercise. 
Every  one  knows  that  this  is  the  case. 
What  more  gentle  means  of  exercising 
the  large  intestines  than  by  the  enema? 

But  the  truth  of  the  matter  is  that  in 

all  cases  of  proctitis  and  constipation  the 

diseased  portion  of  the  gut  is  too  active 

in  its  muscular  movements,  contracting 

spasmodically,  as  it  does,   at  even  the 

suggestion  or  suspicion  of  feces  near  it. 
26s 


Intestinal  Ills 

Every  impulse  of  the  bowels  above  the 
constricted  section  to  force  the  feces  down 
through  the  closed  bore  only  intensifies 
the  spasmodic  action  and  increases  the 
muscular  obstruction,  compelling  the  vic- 
tim to  resort  to  some  one  of  the  many 
drastic  means  of  relief. 

The  enema  does  no  more  than  kindly 
to  dilate  the  constricted  region,  which, 
when  dilated,  evokes  a  harmonious  con- 
certed action  of  all  the  nerves  and  mus- 
cles to  pass  along  and  down  the  burden 
of  feces,  which,  without  the  aid  of  a  flood 
of  water,  they  had  been  incapable  of 
moving,  and  would  have  had  to  leave  to 
poison  the  system. 

The  seventh  objection  is  quite  naive: 
''Inasmuch  as  the  Indians  of  this  country 
had  no  use  for  the  enema,  why  should 
we  resort  to  it?" 

The  all-sufficient  answer  to  this  ob- 
jection is  that  the  Indians  lived  a  natural 
life,  while  ours  is  artificial.  Much  can  be 
said  on  this  point,  but  the  reader  is  surely 

rational  enough  to  follow   out  the  dis- 

266 


Chronic  Constipation 

tinction  suggested.  .  Our  lives  are  much 
more  important  than  were  the  lives  of 
the  aborigines  of  this  country,  and  our 
"demands  of  Nature"  are  more  exigent. 
If  your  life  is  of  no  greater  value  than 
theirs,  for  leisure's  sake  don't  use  the 
enema!  You  will  be  taking  too  much 
trouble.  It  really  should  seem  that  the 
cleanliness  of  the  skin  and  mucous  mem- 
brane, the  care  we  take  of  our  bodies,  is 
an  indication  and  measure  of  our  sense  of 
refinement.  An  ancient  Scripture  hath  it : 
"Let  those  that  are  filthy,  be  filthy  still. " 
It  all  depends  upon  how  you  wish  to  be 
classed — with  the  filthy  or  the  cleanly. 

The  eighth  objection  to  be  noted  is  the 
fear  of  "poking  things"  (points  of  in- 
struments) "into  the  rectum." 

This  looks  like  a  real  objection.     No 

healthy  nor  even  unhealthy  organ,   for 

that  matter,  should  be  "abused."     And 

what  seems  more  likely  to  cause  it  trouble 

than  to  poke  a  hard  or  soft  rubber  point 

or  tube  through   its  vent    in  opposition 

to  its  bent  or  inclination?     Still,  the  mus- 
267 


Intestinal  Ills 

cles  of  the  vent  are  strong,  and  they  soon 
accommodate  themselves  to  the  practice. 
Their  slight  disinclination  is  not  to  be 
considered  alongside  of  the  relief  and  cure 
you  effect  by  the  use  of  the  enema. 

Have  no  fear  that  the  point  will  oc- 
casion disease  when  intelligently  used. 
Always  see  to  it  that  the  point  is 
scrupulously  clean.  Those  made  of  hard 
rubber  or  metal  can  be  kept  so  without 
effort. 

Soft  rubber  points  are  always  foul  and 
dangerous,  especially  after  they  are  used 
a  few  times.  A  good  rule  is  never  to  put 
a  point  higher  in  the  bowel  than  is  abso- 
lutely necessary. 

The  ninth  objection  seems  serious.  It 
is  that  in  taking  an  enema  the  water 
escaping  from  the  syringe  point  will  in- 
jure the  mucous  membrane  where  the 
jet  strikes.  But  on  examination  this 
objection  falls  to  the  ground,  for  it  stands 
to  reason  the  jet  cannot  directly  hit  the 
surface  for  more  than  a  moment.  Im- 
mediately   thereafter  the    accumulation 

268 


Chronic  Constipation 

of  water  will  force  the  jet  to  spend  its 
energy  on  the  increasing  volume,  to  lift 
it  out  of  the  way  so  that  the  continuous 
inflow  may  find  room. 

But  even  were  it  possible  for  the  jet  to 
strike  a  definite  section  of  the  mucous 
membrane  during  the  taking  of  the  ene- 
ma, it  could  do  no  harm  provided  the 
water  be  at  the  proper  temperature. 
And  this  is  true  even  if  a  hydrant  pres- 
sure be  used.  Not  a  few  persons  use  the 
hydrant  pressure  of  their  houses  in  taking 
an  enema.  For  a  really  successful  flush- 
ing of  the  colon  a  considerable  pressure 
is  requisite  to  force  the  volume  up  and 
along  a  distance  of  five  feet,  especially 
when  sitting  upright.  But  it  is  folly  to 
use  a  long  syringe  point,  since  it  is  like 
introducing  one  canal  into  another  for  the 
purpose  of  cleansing  it.  Therefore,  have 
no  fear  from  the  use  of  proper  syringe 
points;  the  jet  of  water  will  not  hurt 
the  mucous  membrane.  My  professional 
brethren  at  least  ought  to  know  that  the 

idea  of  such  harm  is  sheer  nonsense. 
269 


Intestinal  Ills 

The  tenth  objection  to  using  an  enema 
is  in  being  obliged  to  use  it  from  the  fact 
of  having  such  a  disease  as  chronic  inflam- 
mation of  the  rectum  and  colon.  Every 
victim  hates  to  be  compelled  to  do  a 
thing,  and  the  victim  of  proctitis  and 
colitis  is  no  exception  to  the  rule.  In 
fact,  he  is  beginning  to  realize  that  un- 
less he  uses  it  his  system  will  be  poisoned 
by  the  absorption  of  the  sewage  waste. 
Let  the  victim  object  to  the  disease  that 
necessitates  the  use  of  the  enema  and  he 
will  shortly  be  well.  Then  this  objection 
to  the  use  of  the  enema  will  indeed  be 
the  most  important  of  all. 

The  eleventh  objection,  and  the  most 
ridiculous  of  all,  is  that  it  requires  too 
much  time  to  take  the  enema  twice  or 
thrice  daily. 

I  lose  all  patience  with  persons  urging 

this  objection.     Those  that  have  little  or 

no  system  with  their  daily  duties  seldom 

have  time  to  do  anything  of  importance. 

They  suffer  from  "  haphazarditis, "  a  very 

difficult  disease  to  cure,  and  they  are  in 

270 


Chronic  Constipation 

many  cases  hopeless.  Usually  they  are 
an  uncleanly  lot  of  people,  full  of  good 
intentions,  but  their  intentions  though 
taken  often,  seldom  operate  as  an  antidote 
to  foulness.  Their  one  sigh  the  livelong 
day  is:  "Oh,  could  we  be  like  birds  that 
can  stool  while  on  the  wing  or  on  foot!" 
This  feat  of  time-saving  being  hardly 
possible  in  the  present  incarnation  and 
order  of  society,  they  content  themselves 
with  making  a  storehouse  out  of  the  in- 
testinal canal  for  an  indefinite  length  of 
time  as  they  concern  themselves  with 
external  affairs  of  work  or  sport.  A  sorry 
lot  they  are  indeed  when  they  are  laid 
up  for  repairs.  Many  doctors,  I  am  sorry 
to  say,  encourage  with  a  chuckle  this  fool- 
ish practice.  "Any  time  to  stool  you  can 
manage  to  get,  so  that  you  stool  at  least 
once  a  day,  or  once  in  every  two  or  three 
days ;  stool  when  it  is  normal  for  you  to  do 
so. "  This  criminal  advice  just  suits  the 
sleepy,  the  lazy,  or  the  "awfully  busy." 
The  American  habit  of  doing  things  en 

masse,  of  handling  things  in  large  quan- 
271 


Intestinal  Ills 

tities  or  in  bulk,  has  something  to  do  with 
their  don't  care  constipated  habit.  Small 
evacuations  two  or  three  times  a  day  seem 
too  much  like  small  business,  which,  of 
course,  is  a  waste  of  precious  time.  Whole- 
saling, laziness,  lack  of  system,  hurry,  are 
the  cause  of  good-f  or-nothingness  of  body 
and  mind.  It  should  never  be  too  much 
trouble  to  restore  the  lost  impulse  for  stooling 
twice  or  thrice  daily. 

Is  it  a  small  matter  to  have  the  main 
sewer  of  a  city  partly  or  entirely  closed,  or 
the  main  sewer  pipe  of  a  dwelling  stopped 
up?  Think  of  the  dire  results,  notwith- 
standing that  the  windows  and  doors  re- 
main wide  open!  The  Board  of  Health 
would  soon  deal  with  the  negligent  official 
or  landlord.  With  very  few  exceptions, 
"civilized"  men,  women,  and  children  are 
negligent  and  niggardly  caretakers  of  the 
human  dwelling  place — the  marvellous 
body  of  man.  "Lack  of  time,"  "have 
n't  the  time, "  or  "no  time, "  is  the  excuse 
they  give  themselves  and  others. 

Notwithstanding  the  numberless  vic- 

272 


Chronic  Constipation 

tims  around  them,  none  of  these  negligent 
and  niggardly  ones  seem  to  get  alarmed 
until  the  secondary  symptoms,  such  as  in- 
digestion, gout,  rheumatism,  or  disease  of 
some  vital  organ,  are  sufficiently  annoying 
to  demand  attention.  But  I  have  full  faith 
in  humanity.  Man  does  the  best  he  knows 
how,  as  a  general  rule.  But  often  he 
doesn't  know  how;  he  needs  enlightening. 
The  hints  I  have  given  will,  I  am  con- 
fident, be  considered  and  acted  upon  by 
all  to  whose  attention  they  are  brought, 
for  by  acting  upon  them,  normal  bodies 
and  minds  will  result,  and  blessings  at- 
tained heretofore  considered  impossible. 
Normal  health  depends  on  right  doing 
and  being.  Eternal  vigilance  is  the  price 
to  be  paid  for  the  attainment  and  main- 
tenance of  the  goal  of  normal  life  and 
progress.  Eliminate  all  waste  material 
from  the  body  and  all  shifty  vermin  from 
the  mind,  and  the  millennium  for  all 
things  in  the  universe  will  soon  dawn. 


273 


FOURTEEN    REASONS 

Why  We  Should   Bathe   Internally 
as  Well  as  Externally 

1.  Because  very  few  persons  are  free 
from  chronic  inflammation  of  the  anus, 
rectum,  and  sigmoid  flexure,  which  causes 
contraction  of  the  caliber  of  the  organs. 

2.  None  escape  self -poisoning  from 
the  gastro-intestinal  canal.  Many  are 
constantly  being  poisoned  from  the  en- 
trance of  bacterial  and  other  toxic  sub- 
stances into  the  system. 

3.  Nine-tenths  of  the  ills  that  afflict 
mankind  have  their  origin  in  a  foul  di- 
gestive apparatus  and  a  consequently 
poisoned  body. 

4.  Disease  of  the  anus,  rectum,  and 

sigmoid  flexure  results  in  from  two-thirds 

to  three-fourths  of  the  feces  being  daily 

absorbed  into  the  system. 

274 


Fourteen  Reasons 

5.  Feces  unduly  retained  become  very- 
foul  or  malodorous.  If  the  feces  of  birds 
and  domestic  fowls  and  animals  were  as 
obnoxious  as  that  usually  ejected  by 
man  their  discharges  would  require  im- 
mediate removal  from  human  neighbor- 
hoods. 

6.  Man  is  the  only  creature  that  has 
formed  the  habit  of  making  a  fecal  cess- 
pool of  his  large  intestine ;  hence  his  dis- 
eases of  many  varieties.  There  is  nothing 
wholesome  about  him  and  he  is  quite 
destitute  of  vim,  vigor,  and  push.  The 
fecal  poisoning  of  his  parents  is  stamped 
upon  him,  and  the  unhygienic  condition 
of  his  bowels  makes  matters  worse. 

7.  Man  needs  to  form  the  habit  of 
stooling  as  frequently  as  birds,  fowls,  and 
quadrupeds — at  least  as  many  times  in 
twenty-four  hours  as  he  partakes  of  food. 

8.  Making  a  reservoir  of  the  lower 
bowels  is  not  a  time-saving  habit,  but, 
on  the  contrary,  a  breeder  of  many  poi- 
sons, causing  all  sorts  of  acute  and  chronic 

diseases,  which  demand  much  time  and 
275 


Intestinal  Ills 

attention,  as  countless  numbers  know  to 
their  sorrow. 

9.  You  are  a  factor  in  the  social  and 
business  world ;  then  why  not  look,  feel, 
and  be  your  best  by  simply  adopting 
internal  hygienic  measures  ? 

10.  By  the  use  of  the  Internal  J.  B.  L. 
Cascade  Bath  you  can  secure  two  or 
three  stools  a  day,  as  desired;  and  while 
you  are  preventing  self-poisoning  you  are 
regaining  a  normal  habit  and  natural 
health,  which  for  so  many  years  and  gen- 
erations have  been  denied  you.  Do  not 
longer  perpetuate  the  dire  results  of  a 
foul  alimentary  canal  and  consequently 
diseased  body. 

1 1 .  All  desire  to  be  strong  and  healthy, 
and  many  would  add  beauty  of  form  and 
complexion,  which  is  also  commendable. 
This  can  be  attained  by  preventing  dis- 
ease through  hygienic  attention  and  the 
proper  use  of  water. 

12.  The  gastro-intestinal  canal  is  a 

physiological,    moving   food  supply    for 

the  body,  and,  like  any  other  vessel  that 

276 


Fourteen  Reasons 

has  contained  fermenting  substances,  it 
should  be  emptied  and  cleaned  before  a 
fresh  supply  is  put  into  it.  This  is  only 
a  sensible,  reasonable,  and  cleanly  duty 
to  one's  self. 

13.  Who  can  fear  being  made  sick  by 
adopting  cleanly  habits?  You  have  per- 
haps tried  all  other  means  to  keep  well, 
and  have  failed ;  now  try  intestinal  clean- 
liness— a  method  you  should  have  thought 
of  long  ago. 

14.  Every  one  desires  to  avoid  sur- 
gery, the  taking  of  numerous  medicines, 
and  the  spending  of  money  in  that  way 
— and  they  can  be  avoided  if  you  keep 
clean,  both  internally  and  externally. 


277 


You're  Not  Healthy  Unless 
You're  Clean  INSIDE 

And  the  one  way  to  real  internal  cleanliness — by  which 
you  are  protected  against  ninety  per  cent  of  all  human  ailments 
— is  through  proper  internal  bathing,  with  plain  antiseptic 
warm  water. 

There  is  nothing  unusual  about  this  treatment — no  drugs, 
no  dieting — nothing  but  the  correct  application  of  Nature's 
own  cleanser.  But  only  since  the  invention  of  the  J.  B.  L. 
Cascade  has  a  means  for  proper  internal  bathing  existed. 

Only  one  treatment  is  known  for  actually  cleansing  the 
colon  without  the  aid  of  elaborate  surgical  apparatus.    This  is 

THE  INTERNAL  BATH 

By    Means    of   the 

J.  B.  L.  Cascade 

Prof.  Metchnikoff,  Europe's  leading  authority  on  intes- 
tinal conditions,  is  quoted  as  saying  that,  if  the  colon  and  its 
poisonous  contents  were  removable,  people  would  live  in  good 
health  to  twice  the  present  average  of  human  life. 

Dr.  A.  Wilfred  Hall,  Ph.D.,  L.L.D.,  and  W.  E.  Forest, 
B.D.,  M.D.,  two  world-famous  authorities  on  internal  bathing, 
are  among  the  thousands  of  physicians  who  have  given  their 
hearty  and  active  endorsement  and  support  to  the  J.  B.  L. 
Cascade  treatment. 

Fully  half  a  million  men  and  women  and  children  now  use 
this  real  boon  to  humanity — most  of  them  in  accordance  with 
their  doctor's  orders. 

LET  DR.   TYRRELL  ADVISE  YOU 

Dr.  Tyrrell  is  always  very  glad  of  an  opportunity  to  con- 
sult freely  with  anyone  who  writes  him — and  at  no  expense  or 
obligation  whatever.  Describe  your  case  to  him  and  he  gives 
you  his  promise  that  you  will  learn  facts  about  yourself  which 
you  will  realize  are  of  vital  importance.  You  will  also  re- 
ceive his  book,  "The  What,  the  Why,  the  Way,"  which  is 
a  most  interesting  treatise  on  internal  bathing.  Consultation 
with  Dr.  Tyrrell  involves  no  obligation. 

CHARLES  A.  TYRRELL,  M.  D. 

134  W.  65th  Street,  New  York 


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SCALY,  CRACKED  SKIN 

If  You  Value  a   Good   Complexion 

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Among  the  necessities  of  life  there  is  one  to  which  few 
people  pay  the  attention  they  ought,  and  that  is  Soap.  Yet 
it  is  undoubtedly  a  most  important  matter,  for  the  skin  is  a 
very  delicate  and  sensitive  organ,  and  the  constant  applica- 
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Dr.  Tyrrell  has  given  this  matter  long  and  profound  con- 
sideration and  now  offers  to  the  public  a  SOAP  that  leaves 
nothing  to  be  desired.  It  is  not  only  absolutely  free  from  any 
deleterious  substance,  but  is  a  perfect  antiseptic  and  healing 
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rough,  cracked  and  scaly  conditions.  It  is  invaluable  for  TAN, 
FRECKLES,  SUNBURN,  Etc.,  and  is  a  perfect  hygienic 
safeguard  against  cutaneous  disorders.  It  is  a  positive 
pleasure  to  use  it  for  the  toilet  or  bath,  as  it  leaves  such  a 
grateful,  refreshing  after-effect. 

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CHARLES  A.  TYRRELL,  M.  D. 

Formerly  President  of 

Tyrrell  Hygienic   Institute 

134  W.  65th  Street,  New  York  City 


Sufferers  from  Catarrh 

THERE  IS   GLORIOUS  NEWS  FOR  YOU. 
No  matter  how  much  you  may  suffer  from  that  most  dis- 
tressing and  inconvenient  complaint,  a  speedy  and  effective 
release  from  your  sufferings  is  now  offered  to  you. 

T55  J.B.L.CATARRH  REMEDY 

Isoneof  those  sterling  specifics  whose  curative  effects  are  quickly 

realized  on  the  first  trial.     It  is  intended  to  be  used  in  connection 

with  the  flushing  treatment,  and  the  two  used  in  conjunction 

RARELY    FAIL    TO    EFFECT    A    CURE. 

Catarrh  is  first  caused  by  inflammation  of  the  membrane 
of  the  nasal  cavities  and  air  passages,  which  is  followed  by 
ulceration,  when  nature,  in  order  to  shelter  this  delicate 
tissue,  and  protect  the  olfactory  nerves,  throws  a  tough 
membrane  over  the  ulcerated  condition. 

Flushing  the  Colon  lays  the  foundation  for  recovery,  but  the 
membrane  must  be  removed,  and  for  that  purpose  the  J.  B.  L. 
Catarrh  Remedy  IS  WITHOUT  AN  EQUAX. 

It  is  composed  of  several  kinds  of  oils,  and  gently,  but 
effectually,  removes  the  membrane  that  nature  has  built  over 
the  inflamed  parts,  while  its  emollient  character  soothes  and 
allays  the  inflammation.  These  drugs  are  not  absorbed  into 
the  system,  but  act  only  locally. 

THE    MOST  OBSTINATE    CASE   WILL    READILY  YIELD 
TO    THIS   TREATMENT. 

The  price  is  One  Dollar  per  bottle,  which,  in  view  of  its  mar- 
vellous curative  power,  is  a  veritable  gift,  and  with  each  bottle 
we  furnish  an  inhaler  specially  manufactured  for  the  purpose. 
Two  bottles  will  usually  effect  a  cure — though  one  has  been 
frequently  known  to  do  so  in  mild  cases — but  in  the  event  of 
any  one  taking  six  bottles  without  being  cured,  we  will  forfeit 

ONE    HUNDRED    DOLLARS, 
now  deposited'in  the  Lincoln  Trust  Co.  of  New  York,  if  they  can 
honestly  make  oath  that  they  have  faithfullyused  the  remedy  ac- 
cording to  the  directions,  and  have  received  no  benefit  from  it. 

YOU    CANNOT    AFFORD 
to  neglect  this  opportunity  of  ridding  yourself  of  this  most 
distressing  complaint,  which,  if  neglected  too  often 

LEADS    TO    CONSUMPTION. 
DELAYS     ARE    DANGEROUS. 

CHARLES  A.  TYRRELL.  M.D. 

FORMERLY   PRESIDEN 

TYRRELL'S  HYGIENIC  INSTITUTE, 


134  WEST  65th  STREET 
NEW    YORK 


The  J.  B.  L.  Antiseptic 
Tonic 

should  always  be  used  when  introducing 
water  into  the  intestines.  The  use  of 
this  preparation  renders  the  water  com- 
pletely sterile  unless  it  be  notoriously 
impure.  Such  water  should  never  be 
used.  But  the  Antiseptic  Tonic  possesses 
another  important  property  which  is 
most  valuable  in  cases  of  Constipation, 
for  it  acts  as  an  admirable  tonic  on  the 
muscular  coat  of  the  colon,  strengthen- 
ing it  and  restoring  it  to  normal.  For 
these  reasons  it  is  invaluable.  Owing 
to  the  importance  of  using  the  tonic,  I 
have  arranged  to  make  it  as  inexpensive 
as  possible  and  am  prepared  to  furnish 
it  (to  users  of  the  Cascade  only) 
in  one  pound  air-proof  cans  at  the  price 
of  $1.00;  by  mail  twenty  cents  extra. 
You  can  buy  this  at  your  druggist  and 
save  mail  charges. 

Charles    A.   Tyrrell,    M.D. 

134  West  65th  Street,  New  York  City 


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